Osteosarcoma is the most common malignant bone cancer; occurring usually in the metaphyseal region of tubular long bones.

It takes a huge force to break a bone.

The classical metaphyseal corner or bucket handle fracture is virtually pathognomonic for abuse.

Rib fractures are very common and highly specific for abuse in young children less than 2 year.

Fractures of the acromion, sternum and spinous processes are so rare in other conditions, that this affords them a high specificity for abuse.

Occipital impression and other skull fractures occur when the head strikes a solid object.

Although buckle fractures are a common type of pediatric fracture, an adult can get a buckle fracture as well. Basically, a buckle fracture occurs when there is plastic deformation (basically bending leading to compression of the cortex, or outer surface of bone) and a complete fracture of the cortex in the transition area of metaphyseal bone to diaphyseal bone (area where woven bone meets up with sheet-like bone). This happens more often in children because their bones are not mature and the transition area is not as strong as that of a skeletally mature adult. However, the biomechanic characteristics of the transition region can predispose to local failure with a resultant buckle or torus fracture, rather than a transverse fracture, in either children or adults. It just happens much more commonly in kiddos!

Red bone marrow is found in spongy bone located mostly in the ends of the long bones.
Red marrow is found mainly in the flat bones such as hip bone, breast bone, skull, ribs, vertebrae and shoulder blades, and in the cancellous ("spongy") material at the proximal ends of the long bones femur and humerus.

Brachyolmia

* Brachyolmia, Hobaek type * Brachyolmia, Maroteaux type * Brachyolmia, Toledo type * Brachyolmia, autosomal dominant type

Brachyolmia is characterized by childhood onset short trunk-short stature and generalized platyspondyly without significant epiphyseal or metaphyseal changes in the long bones. There are four main types: The Hobaek type: short stature commencing in late childhood or early teens. The shortness is mainly limited to the trunk. The Toledo type: probably identical to the Hobaek type with regard to the skeletal and vertebral changes, but patients also have abnormal excretion of glycosaminoglycans and peripheral punctate corneal opacities. The Maroteaux type: similar phenotype of childhood onset, but with irregular and reduced intervertebral spaces and marked extension of the lateral margins of the vertebrae. Rounding of the anterior and posterior vertebral borders is present. The Autosomal dominant type: symptoms somewhat milder than in the other types. Most cases have scoliosis or kyphosis. This type follows autosomal dominant inheritance, while all other types are autosomal recessive. Besides these four types there are individual cases that can not be classified at present. Based on the inheritance pattern of each type of brachyolmia, the appropriate genetic counseling can be given. Prenatal diagnosis is not available. There is no specific treatment for any of the types of brachyolmia.*Authors: Prof. M. Shohat and Dr G. J. Halpern (July 2004)*.

The above was retrieved from www.orpha.net

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