2. In the very young…
• The skeleton is
composed of mostly
cartilage and is
therefore, pliable with
a decreased
incidence of bone
fractures and
breakage in childhood
3. Mature Bone
• Rigid connective
tissue consisting of
cells;
– Collagen
– Calcium
– Phosphate
4. SKELETON
From Herlihy, B. & Maebius, N. (2000). The human body in health and illness. Philadelphia:
W.B. Saunders.
8. Bone Formation & Maintenance
• Ossification
• Resorption &
Formation
– Local stress
– Vit. D
– Parathyroid hormone
– Calcitonin
– Blood supply
9. TYPES OF BONES
From Herlihy, B. & Maebius, N. (2000). The human body in health and illness. Philadelphia:
W.B. Saunders.
10. SPONGY BONE
• Located in the ends of long bones and the
center of flat and irregular bones
• Can withstand forces applied in many
directions
11. DENSE (COMPACT) BONE
• Covers spongy bone
• Cylinder around a central marrow cavity
• Can withstand force predominantly in one
direction
12. SPONGY BONE AND COMPACT
BONE
From Herlihy, B. & Maebius, N. (2000). The human body in health and illness. Philadelphia:
W.B. Saunders.
13. FUNCTIONS OF BONE
• Framework
• Support
• Movement
• Shape
• Maintain Position
• Attachment of
Muscles
• Protects Organs
• Storage
• Hematopoiesis
• Remodeling
• Reformation
• Movable Joints
14. CHARACTERISTICS OF
JOINTS
• Allow the movement
between bones
• Formed where two
bones join
• Surfaces are covered
with cartilage
• Enclosed in a capsule
23. CHARACTERISTICS OF
MUSCLES
• Made up of bundles of muscle fibers
• Provide the force to move bones
• Assist in maintaining posture
• Assist with heat production
52. Speed of Healing
• Hematoma formation – within hours
• Procallus – within days
• Callus formation – within weeks
• Replacement and remodeling – up
to 4 years
56. Fractures - Treatment
• Reduction
– Closed manipulation
– Traction (skin or skeletal)
– Open reduction and internal fixation (ORIF),
(insertion of prosthesis, screw, plate, nail or
wire).
57. CLOSED REDUCTION
From Black, J., Hawks, J., and Keene, A. (2001). Medical-surgical nursing, ed 6, Philadelphia:
W.B. Saunders.
60. EXTERNAL FIXATION
From Ignatavicius, D., Workman, M. (2002). Medical-surgical nursing, ed 3, Philadelphia: W.B.
Saunders. Courtesy of Smith and Nephew, Inc., Orthopedics Division, Memphis, TN.
61. TYPES OF HIP FRACTURES
• Intracapsular
• Extracapsular
62. HIP REPLACEMENTS
From Mosby’s Medical, Nursing, and Allied Health Dictionary, ed 6, (2002). St.
Louis: Mosby. Courtesy of Zimmer, Inc., Warsaw, IN.
73. CERVICAL SKIN TRACTION
From James, S. Ashwill, R., & Droske, S. (2002). Nursing care of children, ed 2,
Philadelphia: W.B. Saunders.
74. HEAD HALTER TRACTION
From Black JM, Matassarin-Jacobs E (1993) Luckman and Sorensen’s medical-surgical
nursing: a psychophysiologic approach, 4th ed., Philadelphia: W.B. Saunders.
75. BUCK’S SKIN TRACTION
From Black JM, Matassarin-Jacobs E (1993) Luckman and Sorensen’s medical-surgical
nursing: a psychophysiologic approach, 4th ed., Philadelphia: W.B. Saunders.
76. PELVIC SKIN TRACTION
From Black JM, Matassarin-Jacobs E (1993) Luckman and Sorensen’s medical-surgical
nursing: a psychophysiologic approach, 4th ed., Philadelphia: W.B. Saunders.
77. BALANCED SUSPENSION
From Black JM, Matassarin-Jacobs E (1993) Luckman and Sorensen’s medical-surgical
nursing: a psychophysiologic approach, 4th ed., Philadelphia: W.B. Saunders.
78. DUNLOP’S SKIN TRACTION
From Mosby’s Medical, Nursing, and Allied Health Dictionary, ed 6, (2002). St. Louis: Mosby.
79. COMPLICATIONS OF
FRACTURES
• Fat embolism
• Compartment syndrome
• Infection and osteomyelitis
• Avascular necrosis
• Pulmonary emboli
• Venous thrombosis
• Delayed union & nonunion
103. AMPUTATION OF A LOWER
EXTREMITY
• POSTOPERATIVE
– Monitor vital signs
– Monitor for infection and hemorrhage
– Mark bleeding and drainage on the dressing if
it occurs
– Keep a tourniquet at the bedside
– Monitor for pulmonary emboli
104. STUMP WRAPPING
From Black, J., Hawks, J., and Keene, A. (2001). Medical-surgical nursing, ed 6,
Philadelphia: W.B. Saunders.
105. BELOW-THE-KNEE AMPUTATION
• POSTOPERATIVE
– Prevent edema
– Do not allow the stump to hang over the edge
of the bed
– Do not allow the client to sit for long periods of
time to prevent contractures
125. OSTEOARTHRITIS
From Kamal A, Brockelhurst J: Color atlas of geriatric medicine, ed. 2, St. Louis, 1991, Mosby.
SEVERE OSTEOARTHRITIS
HEBERDEN’S NODES
BOUCHARD’S NODES