DISORDERS: HOMEOSTATIC IMBALANCES

Hip Fracture
Although any region of the hip girdle may fracture, the term hip fracture
most commonly applies to a break in the bones associated with the hip
jointthe head, neck, or trochanteric regions of the femur, or the bones
that form the acetabulum. In the United States, 300,000 to 500,000 people
sustain hip fractures each year. The incidence of hip fractures is
increasing, due in part to longer life spans. Decreases in bone mass due
to osteoporosis (which occurs more often in females), along with an
increased tendency to fall, predispose elderly people to hip fractures.
Hip fractures often require surgical treatment, the goal of which is to
repair and stabilize the fracture, increase mobility, and decrease pain.
Sometimes the repair is accomplished by using surgical pins, screws,
nails, and plates to secure the head of the femur. In severe hip fractures,
the femoral head or the acetabulum of the hip bone may be
replaced by prostheses (artificial devices). The procedure of replacing
either the femoral head or the acetabulum is hemiarthroplasty (hem-e-
AR-thro-plas-te; hemi- # one half; arthro- # joint; -plasty # molding).
Replacement of both the femoral head and acetabulum is total hip
arthroplasty. The acetabular prosthesis is made of plastic, and the
femoral prosthesis is metal; both are designed to withstand a high
degree of stress. The prostheses are attached to healthy portions of
bone with acrylic cement and screws (see Figure 9.16 on page 295).
STUDY OUTLINE
Comparison of Female and Male Pelves (p. 249)
1. Bones of the male skeleton are generally larger and heavier than
bones of the female skeleton. They also have more prominent
markings for muscle attachments.
2. The female pelvis is adapted for pregnancy and childbirth. Sexrelated
differences in pelvic structure are listed and illustrated in
Table 8.1 on pages 249250.
Lower Limb (Extremity) (p. 251)
1. Each of the two lower limbs (extremities) contains 30 bones.
2. The bones of each lower limb include the femur, the patella, the
tibia, the fibula, the tarsals, the metatarsals, and the phalanges.
3. The bones of the foot are arranged in two arches, the longitudinal
arch and the transverse arch, to provide support and leverage.
Development of the Skeletal System (p. 258)
1. Most bones form from mesoderm by intramembranous or endochondral
ossification; much of the skeleton of the skull arises from ectoderm.
2. Bones of the limbs develop from limb buds, which consist of
mesoderm and ectoderm.
Clubfoot or talipes equinovarus (-pes # foot; equino- # horse) An
inherited deformity in which the foot is twisted inferiorly and
medially, and the angle of the arch is increased; occurs in 1 of
every 1000 births. Treatment consists of manipulating the arch to
a normal curvature by casts or adhesive tape, usually soon after
birth. Corrective shoes or surgery may also be required.
Genu valgum ( JE -noo VAL-gum; genu- # knee; valgum # bent outward)
A deformity in which the knees are abnormally close
together and the space between the ankles is increased due to a
lateral angulation of the tibia. Also called knock-knee.
MEDICAL TERMINOLOGY
Genu varum (JE -noo VAR-um; varum # bent toward the midline) A deformity
in which the knees are abnormally separated and the lower
limbs are bowed medially. Also called bowleg.
Hallux valgus (HAL-uks VAL-gus; hallux # great toe) Angulation of the
great toe away from the midline of the body, typically caused by
wearing tightly fitting shoes. When the great toe angles toward the
next toe, there is a bony protrusion at the base of the great toe.
Also called a bunion.
Pectoral (Shoulder) Girdle (p. 236)
1. Each of the bodys two pectoral (shoulder) girdles consists of a
clavicle and scapula.
2. Each pectoral girdle attaches an upper limb to the axial skeleton.
Upper Limb (Extremity) (p. 239)
1. Each of the two upper limbs (extremities) contains 30 bones.
2. The bones of each upper limb include the humerus, the ulna, the
radius, the carpals, the metacarpals, and the phalanges.
Pelvic (Hip) Girdle (p.245)
1. The pelvic (hip) girdle consists of two hip bones.
2. Each hip bone consists of three parts: the ilium, pubis, and
ischium.
3. The hip bones, sacrum, and pubic symphysis form the bony pelvis.
It supports the vertebral column and pelvic viscera and attaches
the free lower limbs to the axial skeleton.
4. The true pelvis is separated from the false pelvis by the pelvic
brim.