Anatomy of the Bone

What is bone?

Bone is living tissue that makes up the body's skeleton. There are 3 types of bone tissue, including the
following:

Anatomy of a bone, showing the subchondral tissue, marrow, cancellous tissue, and compact tissue :-

Compact tissue- The harder, outer tissue of bones.

Cancellous tissue. The sponge-like tissue inside bones.

Subchondral tissue. The smooth tissue at the ends of bones, which is covered with another type of
tissue called cartilage. Cartilage is the specialized, gristly connective tissue that is present in adults. It's
also the tissue from which most bones develop in children.

The tough, thin outer membrane covering the bones is called the periosteum. Beneath the hard outer
shell of the periosteum are tunnels and canals through which blood and lymphatic vessels run to carry
nourishment for the bone. Muscles, ligaments, and tendons may attach to the periosteum.

Bones are classified by their shape—

As long (like the femur and forearm), short (like the wrist and ankle), flat (like the skull), and irregular
(like the spine). Primarily, they are referred to as long or short.

There are 206 bones in the human skeleton, not including teeth and sesamoid bones (small bones
found within tendons):-

80 axial bones. This includes the head, facial, hyoid, auditory, trunk, ribs, and sternum.

126 appendicular bones. This includes arms, shoulders, wrists, hands, legs, hips, ankles, and feet.
What are the functions of bone?

Bone provides shape and support for the body, as well as protection for some organs. Bone also serves
as a storage site for minerals and provides the medium—marrow—for the development and storage of
blood cells.

What are the different types of bone cells?

The different types of bone cells include the following:

Osteoblast. Found within the bone, its function is to form new bone tissue.

Osteoclast. A very large cell formed in bone marrow, its function is to absorb and remove unwanted
tissue.

Osteocyte. Found within the bone, its function is to help maintain bone as living tissue.

Hematopoietic. Found in bone marrow, its function is to produce red blood cells, white blood cells, and
platelets.

Fat cells are also found within the bone marrow.

Because of the complexities of a bone's function, from providing strength and support for the body, to
serving as a site for development and storage of blood cells, there are many disorders and diseases that
can affect bone.
Types of Fractures

Bones are rigid, but they do bend or "give" somewhat when an outside force is applied. However, if the
force is too great, the bones will break, just as a plastic ruler breaks when it is bent too far.

The severity of a fracture usually depends on the force that caused the break. If the bone's breaking
point has been exceeded only slightly, then the bone may crack rather than break all the way through. If
the force is extreme, such as in an automobile crash or a gunshot, the bone may shatter.

If the bone breaks in such a way that bone fragments stick out through the skin, or a wound penetrates
down to the broken bone, the fracture is called an "open" fracture. This type of fracture is particularly
serious because once the skin is broken, infection in both the wound and the bone can occur.

Common types of fractures include:

Comminuted fracture. In this type of fracture, the bone shatters into three or more pieces.

Stable fracture. The broken ends of the bone line up and are barely out of place.

Open, compound fracture. The skin may be pierced by the bone or by a blow that breaks the skin at the
time of the fracture. The bone may or may not be visible in the wound.

Transverse fracture. This type of fracture has a horizontal fracture line.

Oblique fracture. This type of fracture has an angled pattern.

Trauma. A fall, a motor vehicle accident, or a tackle during a football game can all result in fractures.

Osteoporosis. This disorder weakens bones and makes them more likely to break.

Overuse. Repetitive motion can tire muscles and place more force on bone. This can result in stress
fractures. Stress fractures are more common in athletes.

Symptoms
Many fractures are very painful and may prevent you from moving the injured area. Other common
symptoms include:

Swelling and tenderness around the injury

Bruising

Deformity — a limb may look "out of place" or a part of the bone may puncture through the skin

Doctor Examination
Your doctor will do a careful examination to assess your overall condition, as well as the extent of the
injury. He or she will talk with you about how the injury occurred, your symptoms, and medical history.

The most common way to evaluate a fracture is with x-rays, which provide clear images of bone. Your
doctor will likely use an x-ray to verify the diagnosis. X-rays can show whether a bone is intact or broken.
They can also show the type of fracture and exactly where it is located within the bone.

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TREATMENT

Internal Fixation for Fractures

RECOVERY

Care of Casts and Splints

A plaster or fiberglass cast is the most common type of fracture treatment, because most broken bones
can heal successfully once they have been repositioned and a cast has been applied to keep the broken
ends in proper position while they heal.

Functional Cast or Brace

The cast or brace allows limited or "controlled" movement of nearby joints. This treatment is desirable
for some, but not all, fractures.

Traction

Traction is usually used to align a bone or bones by a gentle, steady pulling action.

External Fixation

In this type of operation, metal pins or screws are placed into the broken bone above and below the
fracture site. The pins or screws are connected to a metal bar outside the skin. This device is a stabilizing
frame that holds the bones in the proper position while they heal.

In cases where the skin and other soft tissues around the fracture are badly damaged, an external fixator
may be applied until surgery can be tolerated.

External fixation

An external fixator applied to a broken femur (thighbone).

Open Reduction and Internal Fixation

During this operation, the bone fragments are first repositioned (reduced) in their normal alignment,
and then held together with special screws or by attaching metal plates to the outer surface of the bone.
The fragments may also be held together by inserting rods down through the marrow space in the
center of the bone.
Fixation of femur with intramedullary nail

A specially designed metal rod, called an intramedullary nail, provides strong fixation for this thighbone
fracture.

Internal fixation of forearm fracture

In this x-ray, the broken bones of the forearm are held in position by plates and screws while they heal.

Recovery
Fractures take several weeks to several months to heal, depending on the extent of the injury and how
well you follow your doctor's advice. Pain usually stops long before the fracture is solid enough to
handle the stresses of normal activity.

Even after your cast or brace is removed, you may need to continue limiting your movement until the
bone is solid enough for normal activity.

During your recovery you will likely lose muscle strength in the injured area. Specific exercises will help
you restore normal muscle strength, joint motion, and flexibility.