Ch. 48 Disorders of Musculoskeletal Function Trauma, Infection, Neoplasms-1-1

What are common athletic injury sites?

Knee (Osgood-Schlatter), heel (Sever's lesion), and elbow.

Note: These places get hurt a lot when kids play.

What is a contusion?

An injury to muscle or tissue from direct trauma resulting in immediate pain and swelling.

Note: A bruise that hurts right away.

What is a Grade 1 contusion?

Tissue/muscle feels tight with no swelling.

Note: Feels tight but doesn’t puff up.

What is a Grade 2 contusion?

Occasional sudden twinges of pain during activity with possible swelling.

Note: Hurts sometimes and might get puffy.

What is a Grade 3 contusion?

Severe pain and significant swelling appearing immediately.

Note: Big ouch and big swelling right away.

What is a hematoma?

A pool of blood trapped outside a blood vessel, often causing skin discoloration.

Note: A blood lump under your skin.

What is the laceration tetanus rule?

Patients with contaminated/deep wounds who haven't had a booster in >5 years need a tetanus vaccine.

Note: Dirty deep cuts need a shot if it's been a long time.

What are the goals of laceration repair?

Achieve hemostasis and optimal cosmetic results without increasing infection risk.

Note: Stop bleeding and make it look nice without germs.

What is a strain?

Stretching or tearing of the muscle or musculotendinous junction; common in back and hamstrings.

Note: Ouchy muscle stretch.

What is a sprain?

A stretching or tearing of a ligament; common in ankles and wrists.

Note: Ouchy rope that holds joints together.

What is a dislocation?

Joint injury forcing bone ends out of position; symptoms include visible deformity and loss of mobility.

Note: Bone pops out where it shouldn’t be.

Why is hip dislocation urgent?

A time-sensitive medical emergency requiring prompt treatment to prevent permanent complications.

Note: Must fix fast or the hip gets damaged.

How do you reduce a posterior hip dislocation?

Reduced by placing longitudinal traction with internal rotation on the hip (most common type).

Note: Pull the leg and twist in.

How do you reduce an anterior hip dislocation?

Reduced by inline traction and external rotation.

Note: Pull the leg and twist out.

What is a subluxation?

A partial dislocation of a joint.

Note: Halfway popped out.

What are loose bodies?

Small pieces of bone or cartilage floating in joint space causing locking/catching; treated via arthroscopy.

Note: Tiny bone chips that make your joint stick.

What causes rotator cuff tears?

Acute (trauma) or Degenerative (wear and tear, aging >40).

Note: Shoulder breaks suddenly or from old use.

What are rotator cuff tear symptoms?

A dull shoulder ache, pain when lifting hand, and pain disturbing sleep when lying on the side.

Note: Shoulder hurts lifting and sleeping.

What are meniscal tear symptoms?

Locking, clicking, catching, or intermittent inability to fully extend the knee.

Note: Knee sticks or clicks.

What is patellar instability?

Includes dislocation/subluxation; most common in females aged 10-16 .

Note: Kneecap moves around too much.

What is chondromalacia of the patella (CMP)?

"Runner's knee"; softening/erosion of hyaline cartilage causing anterior knee pain.

Note: The knee cap’s cushion gets soft.

What triggers CMP pain?

Stair ascending/descending, squatting, kneeling, or prolonged sitting.

Note: Hurts when bending or sitting long.

Why are hip fractures risky?

Most common reason for urgent surgery in the elderly; high mortality rate without surgery due to immobility complications.

Note: Older people can get very sick if they can’t move.

What is a transverse fracture?

A complete fracture with a perpendicular break line.

Note: Bone breaks straight across.

What is an oblique fracture?

A complete fracture with a diagonal orientation.

Note: Bone breaks sideways-slanted.

What is a spiral fracture?

Created by torsional force, presenting with a rotated appearance.

Note: Bone twists and cracks like a candy cane.

What is a comminuted fracture?

Bone is divided into more than two segments.

Note: Bone breaks into lots of pieces.

What is a bowing fracture?

An incomplete fracture in children; microfractures create a bend/plastic deformity.

Note: Kid bone bends but doesn’t snap.

What is a greenstick fracture?

An incomplete fracture where a portion of the cortex/periosteum remains intact.

Note: Bone bends and cracks like a green twig.

What is a torus fracture?

An impaction injury causing buckling of the cortex.

Note: Bone crunches in like a dent.

What is an open (compound) fracture?

A break in the skin near the fracture; high risk for infection and impaired healing.

Note: Bone break + skin break = germs can get in.

What is a pathologic fracture?

Caused by conditions weakening the bone (osteoporosis, tumors).

Note: Bone breaks because it was weak before.

What is fracture healing stage 1?

Hematoma formation (immediate to 1 week).

Note: Blood clot forms first.

What is fracture healing stage 2?

Fibrocartilaginous callus formation (stabilizes fracture).

Note: Soft glue holds bone together.

What is fracture healing stage 3?

Bony callus formation (replaces tissue callus).

Note: Hard bone starts growing.

What is fracture healing stage 4?

Bone remodeling (solid bone replaces spongy bone).

Note: Bone becomes strong and normal again.

What systemic factors impair healing?

Advanced age, obesity, anemia, diabetes, steroids, malnutrition, and smoking.

Note: Old age and unhealthy habits slow healing.

What is malunion?

A fracture that heals abnormally (bent or twisted).

Note: Bone heals crooked.

What is nonunion?

Fractures that fail to heal due to low blood supply or infection.

Note: Bone doesn’t grow back together.

What is acute compartment syndrome?

A medical emergency where pressure rises in muscle fascia, limiting blood flow.

Note: Big pressure squeezes the muscles too tight.

What is the hallmark of compartment syndrome?

Muscle pain that is stronger than expected from the injury.

Note: Pain that’s WAY too bad for the injury.

How is compartment syndrome treated?

Fasciotomy (an incision to relieve pressure).

Note: Doctors cut the covering of muscles to let pressure out.

What is complex regional pain syndrome (CRPS)?

Excess/prolonged pain and inflammation, often following a wrist fracture.

Note: Pain sticks around way too long.

What is fat embolism syndrome (FES)?

Fat lodging in blood vessels after long bone fractures (femur/tibia/pelvis).

Note: Fat blobs get stuck in blood after big bone breaks.

What are FES signs?

Rapid breathing, mental confusion, and petechial rash (chest/neck) appearing within 12-72 hours.

Note: Fast breathing, confused brain, and tiny red dots.

What is osteomyelitis?

Bone infection, most commonly caused by Staphylococcus aureus.

Note: Germs infect the bone.

What is a sign of chronic osteomyelitis?

Presence of fistulous tracts from skin to bone.

Note: Little tunnels from skin to bone.

What is Pott disease?

Tuberculosis of the spine (TB Spondylitis).

Note: TB that attacks the spine.

What is osteonecrosis (ON)?

Death of bone tissue due to lack of blood supply; causes include steroids, alcohol, and sickle cell anemia.

Note: Bone dies when blood can’t reach it.

What is osteosarcoma?

Most common bone cancer; aggressive; affects children/adolescents (median age 12); found in metaphyses of long bones.

Note: Bad bone cancer in kids.

What is Ewing Sarcoma?

Second most common; affects children (median age 15); metastasizes to lungs/bones.

Note: Another kid bone cancer that spreads.

What is chondrosarcoma?

A cartilage-producing tumor; affects adults (40-75); slow-growing in the central skeleton.

Note: Adult bone tumor from cartilage.

What is metastatic bone disease?

Bone is the third most common organ for metastasis; pain is more severe at night.

Note: Cancer from elsewhere spreads to bone.

What is an osteochondroma?

The most common benign bone tumor.

Note: Harmless bone bump.

What is an osteoid osteoma?

A benign tumor in the cortex of long bones (tibia/fibula); main symptom is pain.

Note: Tiny bone tumor that hurts.

What is a giant cell tumor?

A benign tumor in knee area (ages 20-40); can become malignant.

Note: Knee tumor that might turn dangerous.