1108
U N I T 1 2
Musculoskeletal Function
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Scoliosis is a lateral curvature of the spine. It
is classified as congenital, which results from
defects in vertebral development; neuromuscular,
which is caused by diseases such as cerebral
palsy; and idiopathic, which is the most common
form. Idiopathic scoliosis affects girls more
often than boys and usually becomes evident
between age 10 years and skeletal maturity.The
treatment of scoliosis depends on the severity
of the deformity and the likelihood of curve
progression. Curves between 30 and 40 degrees
usually are considered for bracing, and those
greater than 40 to 45 degrees are considered for
surgery.
SUMMARY CONCEPTS
(continued)
R E V I EW E X E R C I S E S
1.
A 34-year-old football player dislocates his hip
during a game.
A.
Explain the need for immediate reduction of the
dislocation based on the vascular anatomy of
the hip.
2.
A 39-year-old man is in intensive care after a
motorcycle accident in which he skidded across
the pavement on his right side. He has fractures
of his right femur, pelvis, and several ribs on the
right side. His right leg was crushed beneath the
motorcycle, and he is beginning to lose movement
in that leg.
A.
What are the priorities in treating his orthopedic
injuries? What are the available options for
stabilizing his leg?
B.
What risk factors for complications of fractures
are present?
C.
What are the symptoms of compartment
syndrome, and how is it treated?
3.
A 73-year-old woman with a history of breast
cancer sustained a comminuted fracture in the mid-
diaphysis of her left humerus when her husband
lifted her up in bed. She has multiple lucent lesions
scattered throughout her proximal humerus,
radius, and ulna. She was recently hospitalized
for confusion and found to have diffuse bone
metastases.
A.
What would you consider to be the most likely
cause of her fracture?
B.
What are the most common sites for bone
metastasis?
C.
Explain the treatment goals for persons with
pathologic fractures.
4.
A 14-year-old boy complains of recent pain and
swelling of the knee, with some restriction in
movement. Although he thinks he may have injured
his knee playing football, his mother insists that he
be seen by an orthopedic specialist and raises the
possibility that the boy may have an osteosarcoma.
A.
Use the information that osteosarcoma
originates in sites of maximal growth velocity to
explain the site of this boy’s possible tumor.
B.
What diagnostic tests could be used to establish
a diagnosis of osteosarcoma?
C.
The boy and his family are concerned that the
boy will require radical surgery with amputation
of the leg. How would you go about explaining
possible treatment options to him?
5.
A newborn girl was found to have developmental
dysplasia of the hip during a routine screening
examination.
A.
Describe the anatomic abnormalities that are
present in the disorder.
B.
Explain the need for early treatment of
developmental dysplasia of the hip.
R E F E R E N C E S
1. National Centers for Disease Control and Prevention, Centers for
Disease Control and Prevention.
CDC Injury Fact Book
. Atlanta,
GA: Centers for Disease Control and Prevention; 2006.
2. American Academy of Orthopaedic Surgeons.
Overuse injuries
in children
. 2012. Available at:
cfm?topic=A00613. Accessed August 21, 2013.
3. Paterno MV, Taylor-Haas JA, Myer GD, et al. Prevention of
overuse sports injuries in young athletes.
Orthop Clin North Am.
2013;44(4):553–564.
4. Landry GL. Sports medicine. In: Kliegman LM, Stanton BF, St.
Genelli JW, et al., eds.
Nelson Textbook of Pediatrics
. 18th ed.
Philadelphia, PA: Saunders Elsevier; 2011:2401–2418.
5. Sarwark JF, ed.
Essentials of Musculoskeletal Care
. 4th ed.
Rosemont, IL: American Academy of Orthopedic Surgeons
and American Academy of Pediatrics; 2010:58–66, 108–127,
230–240, 243–279, 303–327, 669–674, 684–691, 700–707.
6. Weintraub W.
Tendon and Ligament Healing: A New Approach
to Sports and Overuse Injury
. Brookline, MA: Paradigm
Publications; 2003:11–47.
7. Presti M, Kon E, Marcacci M. Nonoperative biologic treatment
approached for partial Achilles tendon lesion.
Orthopedics.
2010;33(2):120–124.
8. Mercier LR.
Practical Orthopedics
. 6th ed. Philadelphia, PA:
Mosby Elsevier; 2008:7–28, 55–87, 158–161, 193–213, 215–241.
9. Quillen DM, Wuchner M, Hatch RL. Acute shoulder injuries.
Am Fam Physician
. 2004;70:1949–1954.
10. Moore KL, Dalley AR, Agur AMR.
Clinically Oriented
Anatomy
. 6th ed. Philadelphia, PA: Wolters Kluwer Health/
Lippincott Williams & Wilkins; 2010:508–510, 626–642,
663–685, 673–685.
11. Pujalte GG, Zaslow TL. A practical guide to shoulder injuries in
throwing athletes.
J Fam Pract.
2013;62(4):175–180.
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Med Clin North Am
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