Musculoskeletal System: Medications, Treatments, Disorders, and Fracture Types

Medications

  • NSAIDs (Nonsteroidal Anti-Inflammatory Drugs)
    • Role: reduce inflammation.
    • Important note: NSAIDs are not steroids.
    • Benefit: fewer monitoring requirements than steroids, making them a nonsteroid option that is often helpful.
    • Example given: ibuprofen.
    • Why it matters: steroids require extensive monitoring depending on duration, mode of administration, and other factors; thus a nonsteroid option like an NSAID can be preferable in many cases.
  • Muscle relaxants
    • Role: reduce musculoskeletal pain and skeletal muscle tension.
    • Example given: SOMA.

Treatments

  • Laminectomy
    • Definition: excision (removal) of the posterior arch of a vertebra.
    • Note: involves removing a small piece from the back to relieve pressure or improve function.
  • Osteoplasty
    • Definition: scraping and removal of damaged bone from a joint.
    • Purpose: used when a joint is not functioning properly; removes material that obstructs movement or causes pain.
  • Prosthesis
    • Definition: an artificial organ or body part replacement (prosthetics).
    • Examples: prosthetic leg, prosthetic arm, prosthetic finger, breast tissue prostheses.
    • Additional note: a wig is also considered a prosthesis.
  • Occupational therapy (OT) vs Physical therapy (PT)
    • Occupational therapy
    • Purpose: increase function and prevent disability through work and play for independence in daily living.
    • Physical therapy
    • Purpose: physical rehabilitation and prevention of disability through movement, massage, exercise, and other therapeutic methods.
    • Mnemonic to distinguish
    • Physical therapy focuses on a body part or movement (e.g., rehab of a leg after surgery).
    • Occupational therapy focuses on daily living activities and independence.
    • Key takeaway: OT and PT are similar goals (rehabilitation and reducing disability) but differ in modalities and focus areas (daily living vs. specific body-part movement).

Common disorders

  • Paraplegia
    • Definition: paralysis of the lower extremities (legs).
  • Tetraplegia / Quadriplegia
    • Definition: paralysis involving all four extremities (both arms and legs).
  • Scoliosis
    • Definition: lateral curvature of the spine (curvature to the side).
    • Clarification: lateral means toward the side rather than straight up-and-down.
    • Visual cue: the spine may curve in an S-shaped pattern.
    • Common treatment: orthotics or braces (bracing to support and straighten the spine).
  • Kyphosis
    • Definition: exaggeration of the normal forward bend of the spine (humpback).
    • Treatment: orthotics (braces) are commonly used to manage the condition.

Fractures: types and concepts

  • Open vs Closed fractures
    • Closed fracture (also called simple fracture): bone breaks but does not protrude through the skin.
    • Open fracture (also called compound fracture): bone protrudes through the skin, creating a wound and higher risk of infection.
  • Specific fracture patterns (as illustrated in the figure)
    • Transverse
    • Definition: fracture that runs across the bone, perpendicular to its long axis.
    • Mnemonic: to think of it as a transverse cut across the bone (as if crossing the globe).
    • Spiral
    • Definition: fracture spirals around the bone, typically from a twisting motion.
    • Comminuted
    • Definition: bone is broken into multiple fragments or pieces.
    • Impacted
    • Definition: one end of the bone is driven into another portion, causing compression and fracture through impact.
    • Everyday analogy: imagine landing from a height and compressing the bone at the point of impact (e.g., landing on feet from a second story).
    • Greenstick
    • Definition: partial fracture, more common in children; the bone bends and cracks but does not break completely due to ongoing bone pliability.
    • Metaphor: like bending a young vine that bends and cracks without snapping entirely.
    • Oblique
    • Definition: fracture line runs at an angle across the bone.
  • Open vs Closed in the context of oblique fractures
    • Can have a closed oblique fracture (bone fracture without skin break) or an open oblique fracture (bone protruding through the skin).
  • Practical note
    • Regardless of fracture type, stabilization of the affected limb is essential.

Additional context and practical implications

  • Orthotics and braces are commonly used for spine-related conditions (scoliosis and kyphosis) to improve alignment and function without surgery.
  • The choice between medications (NSAIDs vs steroids) has practical implications for monitoring, side effects, and long-term risk management in musculoskeletal care.
  • Prostheses and rehabilitation therapies (OT/PT) play critical roles in restoring independence and movement after injury or surgery.
  • Ethical and practical implications include ensuring proper monitoring for steroid use, infection risk with open fractures, accessibility to PT/OT services, and quality of life considerations with prosthetic devices.

Quick recall prompts (for study)

  • What is the difference between an NSAID and a steroid in terms of monitoring and risks?
  • How does laminectomy differ from osteoplasty?
  • What is the key distinction between OT and PT?
  • Define paraplegia and tetraplegia/quadriplegia.
  • List the fracture types: transverse, spiral, comminuted, impacted, greenstick, oblique.
  • Why are orthotics commonly used for scoliosis and kyphosis?