course material

1. Health and medical assignment
Attached.Running head: FRACTURES IN DUCHENE MUSCULAR DYSTROPHYFractures in
Duchene Muscular DystrophyName of StudentInstitutional Affiliation1FRACTURES IN
DUCHENE MUSCULAR DYSTROPHYFractures in Duchene Muscular DystrophyIn this
respect, osteoporosis is a systematic disorder typified by low bone mass, as well asa
resultant escalation in brittleness and vulnerability to fracture (Powel’s et al. 2014).
Thedecrease in weight-bearing activity as a result of such weakness directly hinders accrual
of bonemass, with a detraction evident in bone mineral content and lower limb strength
before the lossof independent ambulation (Hen wood & Binkovitz 2009). For instance, a
study by Larson andHenderson (2000) showed that lumbar bone mineral density (BMD) fell
from an initial Z-scoreof -0.8 to a score of -1.7 following the loss of ambulation. The bone
mineral density of femuralso descended from an initial Z-score of -1.6 to a very low Z-score
of -3.9. Such drops in BMDmainly increase the risk of long bone fracture in children with
DMD. Without proper and timelyintervention, most of DMD patients also face the danger of
acquiring severe scoliosis, which islikely to necessitate surgical intervention for
stabilization.Related investigations have also shown that corticosteroid treatment provokes
vertebralfractures in 19-38% of patients diagnosed with Duchene muscular dystrophy,
which areinfrequent in their steroid-naïve counterparts (Powel’s et al. 2014; Gordon et al.
2011; Fallon,2013). Such findings may be partly attributed to the shielding impact of spinal
surgery fortreating scoliosis in patients who are steroid-naïve, though this may be difficult
to establish.Deferred puberty, which is another possible side-effect of corticosteroid
therapy, posesadded risk for poor bone health for this patient category (Dooley et al. 2010).
While fractures, ingeneral, are a common occurrence in Duchene muscular dystrophy, an
amplified prevalence offractures has been determined with prolonged treatment using
glucocorticoids (Pereira & Farrar2015).2FRACTURES IN DUCHENE MUSCULAR
DYSTROPHYIn summary, given the risk factors discussed in this section, boys presenting
with Duchenemuscular dystrophy have a considerably lower bone mineral density
compared to their healthycounterparts and are thus more susceptible to adverse bone
outcomes and fractures (MorrisonNasik et al. 2015). What is known is that besides being
painful, fractures in Duchene musculardystrophy have considerable implications for
mobility. Given the positive outcomes l…