Deformities of Skeleton

When the skeletal system becomes weak, it results in deformation. Some of the causes of deformations are as follows:

 

Genetical

Deformation of skeleton may be hereditary such as cleft palate, microcephaly, arthritis, osteoarthritis etc. In cleft palate the palatine process of maxilla and palatine fail to fuse. It can lead to inhalation of food into the lungs. Surgery is the only possible cure.

Microcephaly, the small sized skull is caused by some genetic defect. Arthritis covers over 100 different types of inflammatory or degeneration diseases that damages the joint, osteoarthritis is the most common chronic arthritis, which is a degenerative joint disease of the joints of knee and hip bone caused by genetic defect.

 

Hormonal

Bones become thinner, weaker and less flexible with aging. It is due to loss of calcium from bones, a condition known as osteoporosis, which occurs mostly in aged women. It is related to decreased estrogen level. Other factors include, insufficient exercise, diet poor in calcium and protein, smoking etc. The symptoms can be prevented relatively easily by hormone replacement therapy (HRT), in which estrogen is taken, also known as estrogen replacement therapy (ERT) which offers the best protection against osteoporotic space bone fracture.

 

Nutritional Deficiency Disease

In adults vitamin D deficiency leads to a condition known as osteomalacia (osteon bone, malakia, softness). Here the bones are weakened and soften as calcium salts are not deposited. Weight bearing bones of legs and pelvis bend and deform. The main symptom is the pain when weight is put on affected bones. Another vitamin D deficiency disease in childhood is called rickets and is caused by too little calcium and phosphate being added to the bones. This makes the bones too weak and soft to support the weight of the body, causing bowing the legs and bending of the spine. It is treated by vitamin 'D' fortified milk and exposing skin to sunlight to cure disorder.

Slip-Disc: Each intervertebral disc is a cushion like pad which consists of:

(I) Nucleus Pulposus: it is an inner semi-fluid which acts as a rubber ball to give a disc its elasticity and compressibility.

(II) Annulus Fibrosus: It is the strong outer ring of fibro-cartilage, which holds together successive vertebrae. The discs act as shock absorber during walking, jumping, running and to lesser extent to bend laterally. Severe or sudden physical trauma (means an injury) to spines for example, from bending forward while lifting a heavy object may result in herniation of one or more discs. The herniated disc or slipped disc usually involves rupture of annulus fibrosus followed by protrusion of the spongy nucleus pulposus. If protrusion presses on spinal cord or on spinal nerves exciting from cord, generate severe pain or even destruction of these nervous structures. Slip disc is treated with bed rest, traction (pulling) and pain killer. If these fails disc may be removed surgically.

Spondylosis: The immobility and fusion of vertebral joint is called spondylosis and the most common is the cervical spondylosis.

Sciatica: The pain radiating over the course of sciatic nerve is called sciatica. The cause of sciatica may be (a) injury to proximal sciatic nerve (b) a herniated disc (c) improper administration of an injection into the buttock. This may result in a number of lower limb impairment depending on the precise nerve root injury. When sciatic nerve is completely transected (i.e. cut across transversely), the legs become nearly useless. They cannot be reflexed and all foot-ankle movement is lost. Recovery from sciatic injury is usually slow and incomplete.

Arthritis: In this disease the joints in general tend to become swollen, stiffer and painful. Acute form of arthritis usually results from bacterial invasion and is treated with antibiotics. The membrane, lining the joint thickens; fluid production is decreased, which leads to increased friction. Chronic arthritis includes osteoarthritis (inflammation of entire bone), (osteoarthritis), rheumatoid arthritis, (deformation, of finger joint, and soft tissue is also affected) and gouty arthritis (uric acid crystal in the joint of knee or big toe).

 

Repair of Broken Bones

A broken bone is called a fracture. There are many different kinds of fracture. First an x-ray is taken and an x-ray photograph will show up the bones in the body and any breaks can be seen clearly. A fracture is treated by reduction followed by realignment of the broken end. There are two types of reduction, closed reduction and open reduction.

(I) Closed Reduction: The bone ends are coaxed back to their normal position by physician's hand.

(II) Open Reduction: Surgery is performed and the bone ends are secured together with pins or wires. After broken ends are reduced, it is immobilized by a cast or by traction (pulling on a muscle etc. by means of weights) to allow the healing process to begin. Healing time is 8-12 weeks, but it is much longer for large weight bearing bones and for bones of elderly people due to their poorer blood circulation.

The repair process of a simple fracture takes place in four phases.

(A) Hematoma Formation: When a bone is fractured, blood vessels are broken, so much bleeding occurs. The blood around the fracture site forms a hematoma, a mass of clotted blood. The tissue at the fracture site becomes swollen causing a lot of pain.

(B) Callus Formation: Within 3-4 weeks 'soft callus' begins to form. Capillaries grow into the hematoma and clear up the debris. Fibroblasts and osteoblasts migrate into the fracture site and begin to construct bone.

(C) Bony Callus Formation: Osteoblasts and osteoclasts continue to migrate inward, multiply rapidly and gradually convert the soft callus into bony callus. Bone formation begins 3-4 Weeks after injury and continues until a firm bony union is formed within 2-3 months later. In the mending process, a ring of new bone tissue is formed round the fracture, so the mended bone is slightly thicker in the region of fracture.

(D) Remodeling: The new bone is now re-modeled, any unwanted bits are broken down and reabsorbed, so the final mend is almost undetectable in an X-ray.