Common Skeletal Injuries

Common skeletal injuries. Again, I'm going to work from the top to the bottom. First off, we're going to look at the skull, or the cranium, in the correct terminology. Injuries to the skull will usually be things like a skull fracture. That's quite a common one that we would see as a result of a head injury. Moving down slightly, if we turn our skeleton around, we have the vertical bodies here, C1 to C7, which is the cervical spine. Now, any damage to this area of the spine can be potentially life-threatening. If we turn the skeleton back round again, now we're going to look at the joints. Here, we have the clavicle. Now, a fracture of the clavicle generally happens when someone lands on the point of their shoulder, and this has been seen quite often in cyclists when they come off their bikes.

Other injuries that can happen here are dislocations at the sternoclavicular joint and the acromioclavicular joint. Another common injury is dislocation of the shoulder, often seen during rugby games as a result of a scrum. Commonly, when a shoulder dislocates, it generally dislocates anteriorly to the front, so this would drop down here, and you end up with the ball of your arm sort of underneath your armpit there, a very strange thing to see, and your shoulder would have like a step in it.

Moving, down we get to the humerus. Now, the humerus, straight fractures there. With the elbow, injuries to the elbow tend to be more tendon related, like you hear tendonitis, such as tennis elbow, golfer's elbow. Tennis elbow is generally on the outside of the joint, golfer's elbow is on the inside of the joint, and often in medical terms, it would be referred to as epicondylitis, which generally means inflammation of the joints and the high line cartilage that cover the bones. We will cover this later.

We come down then to the wrist. And we've got the two bones here, remember we were saying that the radius is thumb side and the ulna is the other side. A common fracture is caused the Colles' fracture, it's often known as the old lady's fracture, losing balance as they age, trip over, they put their hands out and they fracture because their bones aren't so strong here and here. Again, it's often called the Colles' fracture. Another common fracture from a fall is because we always naturally put our hands out is to get a fracture into the scaphoid, which is the small bone just right inside here. It's got a really poor blood supply and as a result, can be very difficult to heal. You can often get malunion or even a condition called Sudeck's atrophy, and this is when, rather than the bone knitting together like it should do, the bone cells fight each other and they don't join at all, and people end up having to have that pinned.

If we turn around the spine again and we have a look, it's quite uncommon to have injuries to the thoracic spine, but you might hear of things, such as a burst fracture. When we get down to the lower spine, the lumbar spine, you often hear people suffering from things, they'll say they've got sciatica, often caused by a prolapsed disc. If we turn round again, we can see that there are discs. If these come out of alignment and they touch a nerve, people get sciatic pain.

Now we're moving on to the lower body and possible injuries here. The first one we're going to look at is the pelvis. We have the pelvis here. You might hear of things like a fracture to the pelvis. Now, that's quite a serious injury; on site, it would be indicated as a very unstable pelvis. Another one that's common as we age is we get osteoarthritis of the hip joint. If we turn the skeleton round here, we've got the hip joint and as you can see probably here, it's a ball and socket joint. Where the ball of the femur goes into the pelvis is called the acetabulum, and both these structures are like this. They both are lined with cartilage. What happens is over time, the cartilage wears away, so you end up with bone grinding against bone. This can be very painful and a person will often say to you they've got severe pain, like going through their groin.

When we look at the leg itself here, the femur, you get fractures to the femur, and that'll be a full leg plaster job, quite a serious fracture. We then move on to the knee itself. Now, the knee is very interesting, quite a complicated structure in some ways. Lots of injuries can happen to the knee so, as you can see, we've got the end of the femur and you've got the head of the tibia, so we've got the tibial plateau, you get little discs that sit here called meniscus, the cartilage, we can get injury to those. When we look at the knee here, normally, you can see it here, where it's got all its ligaments around it, and inside, we have the little menisci, which is here, at the cartilage. An injury that can happen here is something that's called O'Donoghue's triad. This is something that's common with footballers when they say someone's had a serious ligament issue, O'Donoghue's triad means that they have damaged the medial ligament.

But also inside here, although you can't see them, there are two ligaments in a cross called the posterior-anterior ligament. What happens here is the anterior one is snapped, so this allows the tibia to move forward like that on the bone. And at the same time, they damage the medial, which is the inside meniscus or cartilage, and that's called the O'Donoghue's triad, and it's a common football injury.

Another one that some of you might have heard is called jumper's knee. Now, jumper's knee, the correct terminology of that is called Osgood-Schlatters disease, prevalent, generally, in adolescents. And it's where all the muscles, the quadriceps muscles, run into the patella tendon and the patella tendon attaches here on something called the tibial tuberosity, it's like a lump of bone that sticks out. In jumper's knee or Osgood-Schlatters disease, what happens is the pull is so strong on the muscles here that the tendon starts avulsing or moving away from the bone. It's more common in adolescents or people who do jumping activities.

We then get down to the ankle. Now, many, many people suffer from a sprained ankle during their lives. As you can see, there are lots and lots of ligaments and structures around the ankle, and if the ankle is not stable, and people don't have strong proprioception and good musculature around this area, you can get the ankle moving inwards and then we get the swelling and sprains that you're familiar with ankle injuries.