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https://upload.orthobullets.com/topic/9008/images/Cutting cone_moved.jpg
Introduction
  • Wolff's Law
    • bone remodels in response to mechanical stress
  • Piezoelectic charges
    • bone remodels is response to electric charges
    • compression side is electronegative and stimulates osteoblast formation
    • tension side is electropostive and stimulates osteoclasts
  • Hueter-Volkmann Law
    • theory that bone remodels in small packets of cells known as Basic Multicellular Units (BMUs)
    • theory suggest that mechanical forces influence longitudinal growth
    • compressive forces inhibit growth 
    • may play role in scoliosis
Remodeling Mechanism 
  •  Cortical bone 
    • remodels by osteoclastic tunneling (cutting cone)
      • osteoclastic resorption > layering of osteoblasts > layering of lamellae > cement line laid down
      • osteoclast make up head of cutting cone, followed by capillaries and then osteoblasts which lay down the osteoid to fill the cutting cone
      • sclerostin inhibits osteoblastogenenesis to decrease bone formation
    • cortical bone continues to change over time 
      • cortical area decreases as age increases
        • linked to increase fracture risk
      • medullary canal volume increases as age increases
  • Cancellous bone remodels by
    • osteoclastic resorption
    • osteoblastic deposition of layers of lamellae

 

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Questions (13)
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(OBQ10.16) The femur radiograph of a healthy 25-year-old female is compared to the femur radiograph of a healthy 85-year-old female. Which of the following best describes the 25-year-old's femur? Review Topic

QID: 3104
1

Increased cortical thickness and a smaller medullary canal volume

93%

(1880/2015)

2

Decreased cortical thickness and a larger medullary canal volume

2%

(43/2015)

3

Equivalent cortical thickness and medullary canal volume

1%

(23/2015)

4

Increased cortical thickness and larger medullary canal volume

3%

(51/2015)

5

Decreased cortical thickness and a smaller medullary canal volume

0%

(8/2015)

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(OBQ04.231) A 25-year-old male sustains a transverse humeral shaft fracture and undergoes open reduction and internal fixation with rigid compression plating. What kind of bone healing would be expected with this type of fracture fixation? Review Topic

QID: 1336
1

Primary bone healing through haversian remodeling

94%

(1753/1869)

2

Secondary healing through callus formation

1%

(21/1869)

3

Primary healing through callus formation

2%

(32/1869)

4

Endochondral ossification

2%

(32/1869)

5

Secondary healing through osteonal cutting cones

1%

(24/1869)

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