Porth's Essentials of Pathophysiology, 4e

1108

Musculoskeletal Function

U N I T 1 2

4. A 14-year-old boy complains of recent pain and swelling of the knee, with some restriction in movement. Although he thinks he may have injured his knee playing football, his mother insists that he be seen by an orthopedic specialist and raises the possibility that the boy may have an osteosarcoma. A. Use the information that osteosarcoma originates in sites of maximal growth velocity to explain the site of this boy’s possible tumor. B. What diagnostic tests could be used to establish a diagnosis of osteosarcoma? C. The boy and his family are concerned that the boy will require radical surgery with amputation of the leg. How would you go about explaining possible treatment options to him? 5. A newborn girl was found to have developmental dysplasia of the hip during a routine screening examination. A. Describe the anatomic abnormalities that are present in the disorder. B. Explain the need for early treatment of developmental dysplasia of the hip. R E F E R E N C E S 1. National Centers for Disease Control and Prevention, Centers for Disease Control and Prevention. CDC Injury Fact Book . Atlanta, GA: Centers for Disease Control and Prevention; 2006. 2. American Academy of Orthopaedic Surgeons. Overuse injuries in children . 2012. Available at: http://orthoinfo.aaos.org/topic. cfm?topic=A00613. Accessed August 21, 2013. 3. Paterno MV, Taylor-Haas JA, Myer GD, et al. Prevention of overuse sports injuries in young athletes. Orthop Clin North Am. 2013;44(4):553–564. 4. Landry GL. Sports medicine. In: Kliegman LM, Stanton BF, St. Genelli JW, et al., eds. Nelson Textbook of Pediatrics . 18th ed. Philadelphia, PA: Saunders Elsevier; 2011:2401–2418. 5. Sarwark JF, ed. Essentials of Musculoskeletal Care . 4th ed. Rosemont, IL: American Academy of Orthopedic Surgeons and American Academy of Pediatrics; 2010:58–66, 108–127, 230–240, 243–279, 303–327, 669–674, 684–691, 700–707. 6. Weintraub W. Tendon and Ligament Healing: A New Approach to Sports and Overuse Injury . Brookline, MA: Paradigm Publications; 2003:11–47. 7. Presti M, Kon E, Marcacci M. Nonoperative biologic treatment approached for partial Achilles tendon lesion. Orthopedics. 2010;33(2):120–124. 8. Mercier LR. Practical Orthopedics . 6th ed. Philadelphia, PA: Mosby Elsevier; 2008:7–28, 55–87, 158–161, 193–213, 215–241. 9. Quillen DM, Wuchner M, Hatch RL. Acute shoulder injuries. Am Fam Physician . 2004;70:1949–1954. 10. Moore KL, Dalley AR, Agur AMR. Clinically Oriented Anatomy . 6th ed. Philadelphia, PA: Wolters Kluwer Health/ Lippincott Williams & Wilkins; 2010:508–510, 626–642, 663–685, 673–685. 11. Pujalte GG, Zaslow TL. A practical guide to shoulder injuries in throwing athletes. J Fam Pract. 2013;62(4):175–180. 12. Pimentel L. Orthopedic trauma: management of major joint injury. Med Clin North Am . 2006;90:355–382.

SUMMARY CONCEPTS (continued)

■■ Scoliosis is a lateral curvature of the spine. It is classified as congenital, which results from defects in vertebral development; neuromuscular, which is caused by diseases such as cerebral palsy; and idiopathic, which is the most common form. Idiopathic scoliosis affects girls more often than boys and usually becomes evident between age 10 years and skeletal maturity.The treatment of scoliosis depends on the severity of the deformity and the likelihood of curve progression. Curves between 30 and 40 degrees usually are considered for bracing, and those greater than 40 to 45 degrees are considered for surgery. 1. A 34-year-old football player dislocates his hip during a game. A. Explain the need for immediate reduction of the dislocation based on the vascular anatomy of the hip. 2. A 39-year-old man is in intensive care after a motorcycle accident in which he skidded across the pavement on his right side. He has fractures of his right femur, pelvis, and several ribs on the right side. His right leg was crushed beneath the motorcycle, and he is beginning to lose movement in that leg. A. What are the priorities in treating his orthopedic injuries? What are the available options for stabilizing his leg? B. What risk factors for complications of fractures are present? C. What are the symptoms of compartment syndrome, and how is it treated? 3. A 73-year-old woman with a history of breast cancer sustained a comminuted fracture in the mid- diaphysis of her left humerus when her husband lifted her up in bed. She has multiple lucent lesions scattered throughout her proximal humerus, radius, and ulna. She was recently hospitalized for confusion and found to have diffuse bone metastases. A. What would you consider to be the most likely cause of her fracture? B. What are the most common sites for bone metastasis? C. Explain the treatment goals for persons with pathologic fractures. R E V I EW E X E R C I S E S