Taylor Schermer 

October 11, 2018 

Anatomy 

Case Study 1 

What is meant by a, “complete, comminuted, intertrochanteric fracture of the right hip?” 

A complete fracture is a fracture that breaks the continuity of the bone. The bone is 

completely separated. Comminuted is when the bone is broken into several pieces; three or 

more. (AAOS, 2012) An Intertrochanteric fracture occurs between the greater trochanter and the 

lesser trochanter of the femur. (Minnis, 2017) Therefore a, “complete, comminuted, 

intertrochanteric fracture of the right hip,” is a fracture that is completely separated from its 

other half, and broken into multiple pieces between the two trochanters of the femur.  

Draw and label a picture of what you think Margaret’s fracture looks like.  

   

The radiologist reported signs of osteoporosis. Describe the characteristics of an osteoporotic 

femur as seen on an X-ray. (How does it differ in appearance from a normal femur?) 

Osteoporosis occurs when bone resorption occurs faster than bone deposition. (Hott, 

98) It is the lack of homeostasis within the bone because the osteoclasts are breaking down the 

bone tissue/ matrix faster than the osteoblasts can create new bone tissue/ matrix. An 

osteoporotic femur, as viewed on an X-ray, typically cannot be diagnosed until it has lost 30% of 

its bone density. After that, the bone will physically lose volume, which can be observed on an 

X-Ray. The bone will have a decreased cortical thickness in the diaphysis, which is the outer 

layer of the bone. There will also be a decrease in trabeculae within the cancellous bone 

(spongy bone), in both the proximal and distal epiphysis. (Altimimy, 2015) A normal femur under 
an x-ray appears to have more volume than a bone with osteoporosis. 

Describe the microscopic features of osseous tissue that normally help long bones withstand 

lateral stress without break. 

The microscopic features of osseous tissue that allow the bone to withstand lateral 

stress are collagen fibers. Collagen fibers provide the bone with the ability of torque, which 

allows the bone to resist shattering. One-third of the bone is made up of collagen fibers because 

if the whole bone was made out of collagen fibers then it would collapse due to a lack of rigidity. 

(Hott 18-9) 

Describe the microscopic features of osseous tissue that normally help long bones withstand 

compressive stress without breaking.  

The microscopic feature of osseous tissue that provides the bone with the ability to 

withstand compressive stress without breaking is calcium phosphate (mineral salts). (Hott, 17) 

The calcium phosphate makes the bone stiff and able to resist compression. In the epiphysis, 

the trabeculae distribute the weight out to the diaphysis which creates a strong distribution of 

weight/pressure.  

Describe the changes that a broken bone undergoes as it is healing. 

First, the bone creates a hematoma, or a blood clot, from the hemorrhaging blood 

vessels at the fracture site, resulting in inflammation, pain, and swelling. All the bone cells at the 

fracture site die. Cells from the endosteum and the periosteum go to the fracture and form a 

granulation tissue, a soft callus, around the fracture for stabilization. Externally, a callus hyaline 

cartilage surrounds the fracture, while internally, a callus of cartilage and collagen, secreted 
from fibroblasts, form into the marrow cavity, connecting broken bone ends. Osteoblasts start 

forming cancellous bone. Phagocytic cells, immune cells, dispose of any foreign, dead, or 

useless substances and capillaries grow into the tissue. Away from the capillaries osteoblasts 

secrete cartilaginous matrix for calcification in the future. After 3-4 weeks a bony callus is 

formed when the fibrocartilaginous or soft callus turns into bony callus resulting in new 

trabeculae in the spongy bone. This will occur for 2-3 months. For up to the next year the bone 

callus, extra bone tissue, on the shaft of the bone and medullary canal will be reduced by 

osteoclasts, though it may never go away completely. The compact bone will be reconstructed 

on the shaft walls. (Hott, 88-95) 

Works Cited 

“Our Knowledge of Orthopaedics. Your Best Health.” Fractures (Broken Bones) - OrthoInfo - 

AAOS, orthoinfo.aaos.org/en/diseases--conditions/fractures-broken-bones/. 

Altimimy, Qais A. “Imaging of Bone Diseases.” 10 Oct. 2018. 

https://slideplayer.com/slide/10955580/ 

Hott, Tina, Anatomy, Osseous Tissue and Bone Formation Notes, 11 Oct. 2018. 

“Intertrochanteric Fracture: Treatment, Recovery, and More.” Intertrochanteric Fractures - 

Healthline- Minnis, https://www.healthline.com/health/intertrochanteric-fracture#outlook