- condition resulting in soft bones which typically bow and fracture more easily than normal bone
- results from either a dietary deficiency or poor absorption of calcium and/or phosphate
- associated medical conditions (e.g., celiac, kidney or liver disease), surgery (e.g., gastrectomy)
- associated w use of some prescription medications (e.g., phenobarbital).
Osteomalacia
- increased bone mass, but notable fragility resulting from significantly decreased osteoclast activity.
- Pathologic fractures are common
- genetic autosomal dominant trait
adult onset form of osteopetrosis, “stone bone”, marble bone disease, Albers-Schönberg disease,
(infantile and intermediate forms inherited as autosomal recessive traits)
- in pediatric population associated with pathological fractures
- incidence of the condition is low and typically occurs secondary to another medical condition (e.g., malignancy), trauma (e.g., severe burn), long-term medication use (e.g., corticosteroids) or severe dietary deficiencies (e.g., calcium, vitamin D).
Osteoporosis
- genetic condition which causes abnormality in type I collagen synthesis.
- patient bruises easily and has a lifelong history of pathological fractures
- autosomal dominant
Osteogenesis imperfecta, types I and IV, Milder presentations
- genetic condition which causes abnormality in type I collagen synthesis.
- patient bruises easily and has a lifelong history of pathological fractures
- autosomal recessive traits
Osteogenesis imperfecta, types II and III, more severe forms
what pathology?
- Proper handling techniques are critical to the integrity of these patients’ bones since fractures are extremely common.
- Patients will have bowing of long bones, a barrel shape of their rib cage, possible hearing loss, brittle teeth, and near normal sclera.
type IV osteogenesis imperfecta
wedge vs burst fracture?
common cause?
cause - external force on spine (eg. fall, carrying heavy weight, severe forward bend), the forces exceed the ability vertebral body bone to support the load
wedge, compression fracture - anterior vertebral body crush forming a wedge shape
burst - entire vertebral body breaks
what spinal movement are compression/wedge fractures associated with?
what muscles should be stretched?
flexion
stretch antagonistic muscles -
- Shoulder- horizontal adductors, medial (internal) rotators
- Hip- flexors, medial (internal) rotators
