Bone healing requires 3 things
- osteoconduction - scaffold / matrix
- osteoinduction - growth factors
- osteogenesis - cells to produce osteoid
Definition
- property of a matrix that supports the attachment of bone forming cells for subsequent bone formation
Substances
1. Contained Metaphyseal Defect
2. Damaged Metaphyseal
A. One Condyle
B. Both Condyles
3. Deficient Metaphysis +/- collaterals +/- extensor mechanism
Stage 0
Natural history mixed
- depends on size of lesion and diagnosis
- treat if becomes asymptomatic
- may benefit from bisphosphonates
Stage 1 / Normal X-ray, abnormal MRI
Forage: 80% G/E
Bisphosphonates
Stage 2 / Abnormal X-ray with cysts and sclerosis
A: As for Stage I
Young men
FOOSH
- axial load, dorsiflexion and radial deviation
DISI occurs in ulna deviation
Type A Stable acute fracture
A1 Tubercle
Xray
- sclerosis
CT
Non Ossifying Fibroma
A hamartomatous defect in the metaphyseal cortex of skeletally-immature adolescents
Fibrous cortical defect
- < 2cm in diameter
Non ossifying fibromas
- > 2cm
Benign neoplasm of cartilaginous origin composed primarily of myxoid cartilage
Previously thought to be Chondrosarcoma
Very rare tumour
- young adults 10-30
- M:F 2:1
Common upper tibia
- metaphysis of long bones
- lower limb predilection
Tenderness