• Length: A minimum of 150 words per post, not including references
• Citations: At least one high-level scholarly reference in APA per post from within the last 5 years

1. What is the significance of a bone plate?

A bone plate is an internal fixation device that is fixed to the bone with screws on both sides of the fracture. (Singh, 2019). Indications for the use of bone plates include proper restoration of anatomical alignment, when screws alone are not supportive enough, and for load sharing (Singh, 2019).

2. How is bone formed?

The formation of bone termed ossification or osteogenesis, begins in the sixth or seventh week of fetal development and continues to an individual until approximately twenty-five years old  (Breeland, 2021). There are two types of bone ossification, which include intramembranous and endochondral, which both begin with the replacement of mesenchymal tissue; however, there are differences in transformation (Breeland, 2021). 

Intramembranous ossification occurs within the connective tissue membrane and is a  direct conversion of mesenchymal tissue into bone (Gilbert, 2017). During intramembranous Ossification the mesenchymal tissue differentiates into cartilage and then later into bone (Gilbert, 2017). This process is achieved in  four steps which include the clustering of mesenchymal cells where the ossification center forms, then secreted osteo trap osteoblasts turn into osteocytes (Learning , 2021). This then leads to the formation of the trabecular matrix and periosteum , followed by the development of compact bone (Learning, 2021).

Endochondral ossification rapidly replaces hyaline cartilage which serves as a template to completely be replaced by new bone (Learning, 2017). There are five steps of endochondral ossification which begins when the mesenchymal cells differentiate into chondrocytes leading to the formation of the cartilage model of the bony skeleton and the perichondrium (Kearning, 2017). After this formation, the  capillaries penetrate the  cartilage where essentially the perichondrium transforms into periosteum as the primary ossification center develops (Learning, 2017). .The Cartilage and chondrocytes continue to grow at ends of the bone forming  secondary ossification centers  (Learning, 2017). As cartilage grows, capillaries penetrate the spaces of the cartilage and transform the perichondrium into the bone-producing periosteum (Learning, 2017).

3. What is the role of the following bone formation: hormones (GH + sex hormones), Ca2+, stress; low Ca2+ increases PTH.

Hormones – Both the female hormone estrogen and the male hormone testosterone affect bones in men and women (Office of the Surgeons General, 2021). Estrogen in early childhood and early puberty stimulates bone formation resulting in bone growth (Office of the Surgeons General, 2021). Once puberty is complete, the high concentration of estrogen inhibits further growth in height by closing the cartilage plates at the ends of long bone that previously had allowed the bones to grow in length (Office of the Surgeons General, 2021). When there is a decrease in estrogen, rapid bone loss occurs as during menopause.

Testosterone-Stimulates muscle growth which puts greater stress in the bone increasing bone formation and acting as a source of estrogen that turns into fat cells (Office of the Surgeons General, 2021).

Growth Hormone- Secreted from the pituitary gland, growth hormone is responsible for regulation by utilization of insulin-like growth factor-1 (IGF-1) to stimulates both the bone-resorbing and bone-forming cells, but the dominant effect is on bone formation, thus resulting in an increase in bone mass (Office of the Surgeons General, 2021).

Calcium Regulating Hormones- are responsible for healthy bone production. The three calcium regulating hormones include the parathyroid hormone (),  calcitriol, and calcitonin   (Office of the Surgeons General, 2021).

PTH-maintains the level of calcium and stimulates both resorption and formation of bone (Office of the Surgeons General, 2021).

Calcitriol- The hormone derived from vitamin D, which stimulates the intestines to absorb enough calcium and phosphorus and also affects bone directly (Office of the Surgeons General, 2021).

Calcitonin-which inhibits bone breakdown and may protect against excessively high levels of calcium in the blood. (Office of the Surgeons General, 2021).

4. Compare and contrast the various types of fractures.

• Displaced Fracture: bone breaks into two or more pieces and moves out of alignment (Types of Fractures, 2021).

• Non-Displaced Fracture: the bone breaks but remains in alignment  (Types of Fractures, 2021).

• Closed Fracture: the skin is not broken  (Types of Fractures, 2021).

• Open Fracture: the bone has broken through the skin  (Types of Fractures, 2021).

• Avulsion Fracture: when a fragment of bone is separated from the main mass  (Types of Fractures, 2021

• Buckle Fracture: ends are driven into each other also known as the impacted fracture (Types of Fractures, 2021).

• Comminuted Fracture: the bone breaks into several pieces (Types of Fractures, 2021).

• Compression or Wedge Fracture: usually involves vertebral bones Types of Fractures, 2021).

• Greenstick Fracture: the bone is bent not a complete fracture (Types of Fractures, 2021). 

• Linear Fracture: the break is parallel to the bones long axis (Types of Fractures, 2021).

• Oblique Fracture: the break has a curved or sloped pattern (Types of Fractures, 2021).

• Pathologic Fracture: due to a  disease that weakens the bones (Types of Fractures, 2021).

• Spiral Fracture: one part of the bone has been twisted at the break point (Types of Fractures, 2021).

• Stress Fracture: a hairline crack (Types of Fractures, 2021).

• Transverse Fracture: the broken piece of bone is at a right angle to the bones axis (Types of Fractures, 2021).

References

Breeland, G. (2021, May 08). Embryology, Bone Ossification. Retrieved from 

Gilbert, S. F. (2017, January 01). Osteogenesis: The Development of Bones. Retrieved from 

Learning, L. (2017). Anatomy and Physiology. Retrieved from  Ossification Intramembranous ossification follows,Trabecular matrix and periosteum form.

Office of the Surgeon General (US). (2021, January 01). The Basics of Bone in Health and Disease. Retrieved from 

Setiawati, R., & Rahardjo, P. (2018, December 14). Bone Development and Growth. Retrieved

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