Radiographs of the painful area should be obtained, although radiographic signs are often minimal early in the infection. The earliest radiographic evidence of acute hematogenous osteomyelitis is swelling of soft…
ETIOLOGY AND PREVALENCE OF HEMATOGENOUS OSTEOMYELITIS In contrast to direct contamination of the bone from exogenous sources, hematogenous osteomyelitis results when the bone is seeded with bacteria from a distant…
Clinical manifestations of acute hematogenous osteomyelitis of the spine are more difficult to define. The patient may complain of a vague backache as well as generalized malaise, decreased appetite, and…
Except in very young children, the infection rarely extends across the physical barrier of the growth plate. In children younger than 1 year of age, some branches of the metaphyseal…
Direct trauma to the skin overlying the bursa can seed the fluid in an inflamed, swollen bursa with bacteria. The fluid is an excellent medium for bacterial growth, and the…
Peptide and steroid hormones help regulate fracture healing. Growth hormone, insulin, thyroid hormone, cortisol, and gonadal steroids all have important functions throughout the process of fracture healing; each of these…
Clinically, fracture healing is complete when bone strength at the fracture site has been restored to normal and the marrow space is re-formed. This may occur as soon as 6…
STAGES OF HEALING Inflammation The stage of inflammation begins at the time of injury when bleeding at the fracture site from the bone and surrounding soft tissue causes hematoma formation….
Fracture fragments can also be rotationally displaced. After fracture, the distal fragment is rotated along the long axis of the bone by muscle spasm or by the pull of gravity,…
FRACTURE SITES In the initial evaluation of any fracture, the examiner must identify the specific location of the fracture within the bone (see Plate 7-21). The different areas of bone…
