Download Clinical Musculoskeletal Pathology by William F. Enneking PDF

By William F. Enneking

Stressing the significance of correlating the medical presentation, radiologic features and staging experiences with the pathologic findings and diagnostic microscopic beneficial properties of musculoskeletal afflictions and illnesses.

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The growth mechanism is quite sensitive to pressure. If compressive force is placed upon it the rate of growth is retarded. If tension is applied growth is accelerated. If compression is applied asymmetrically and growth is retarded on one side an angular deformity will develop. Growth may be arrested by surgically excising the epiphyseal plate as it has a very limited capacity to regenerate. It may also be temporarily retarded by compressive staples, which when removed may allow growth to resume at a normal rate.

It may also be temporarily retarded by compressive staples, which when removed may allow growth to resume at a normal rate. During the time growth is retarded a thin plate of horizontally oriented trabeculae forms beneath it. When growth resumes and the epiphysis moves away this plate passes into the metaphysis where it may be seen on X-ray in much the same manner as the scar of the old epiphyseal plate is seen in the adult. These lines are known as growth arrest lines. This normal growth through the epiphyseal mechanism is affected by the vascular supply, nutritional status, mineral metabolism, protein metabolism, and various hormonal influences which will be discussed later.

This normal growth through the epiphyseal mechanism is affected by the vascular supply, nutritional status, mineral metabolism, protein metabolism, and various hormonal influences which will be discussed later. G. Physiological Function of Bone The skeleton functions anatomically as a framework to provide sufficient stability to maintain the upright position, as well as to protect the soft visceral organs and to provide levers for locomotion. For these reasons, the matrix of bone, in contrast to the matrix of other connective tissues, achieves rigidity by a unique combination of collagen fibers and hydroxyapatite crystals.

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