I. PATHOLOGIC FRACTURE
DEFINITION
A pathologic fracture is a broken bone that’s caused by a
disease, rather than an injury. Some conditions weaken your
bones, which makes them more likely to break.
Pathological fractures in children can occur as a result of a
variety of conditions, ranging from metabolic diseases and
infection to tumors. Fractures due to benign and malignant bone
tumors should be recognized and managed appropriately by the
treating orthopedic surgeon. The most common benign bone tumors
that cause pathological fractures in children are unicameral
bone cysts, aneurysmal bone cysts, non-ossifying fibromas and
fibrous dysplasia. Non-ossifying fibroma is the most common bone
tumor in kids. It is not a cancer. NOF is benign which means it
is just a collection of abnormal cells that stays where it is
and does not move to other parts of the body.
Causes
In this case, the cause of the client’s pathologic fracture is
related to the Disease Non-ossifying fibroma.
Socio-economic Status
Educational Attainment
Family Background
Number of Siblings 3
Birth order 2
Mother’s occupation Housewife
Father’s occupation Seaman
Other sources of income none
Other people in the house Grandmother
Housing
Level
Materials
Other Notes
Family History
Paternal Maternal
(+)Diabetes Mellitus (-)Diabetes Mellitus
(-)Asthma (-)Asthma
(-)Heart Disease (-)Heart Disease
(-)Cancer (-)Cancer
Medical history
(-) Cardiovascular system
(-) Pulmonary system
(-) GIT/GUT
(-) Hematopoietic system
(-) Endocrine system 2015
(-) Neurological System
(-) Allergies Fracture at the
distal 3rd femur right
2016
Trauma at Right patellar
Cause: Falling accident
Intervention: Cast
2017
Re-fracture at the distal 3rd femur right
Cause: Slipping from garden hose
Intervention: Steinmann Pin Insertion
Pathologic Fracture
Bulbar
EYES conjunctiva Symmetrical, no Normal findings
appeared edema, moist,
transparent with the sclera
few capillaries appeared white,
evident. the pupils
Sclera appeared constrict in
white. response to
No edema or light and dilate
tearing of the when looking at
lacrimal gland. far objects.
Cornea is
transparent,
smooth and shiny
and the details
of the iris are
visible.
The pupils of the
eyes are black
and equal in
size. The iris is
flat and round.
PERRLA (pupils
equally round
respond to light
accommodation),
illuminated and
non-illuminated
pupils
constricts.
Pupils constrict
when looking at
near object and
dilate at far
object. Pupils
converge when
object is moved
towards the nose.
There are no
discoloration of
the enamels, no
retraction of
gums, pinkish in
color of gums
TEETH AND GUMS The buccal mucosa 1 extracted Normal findings
of the client tooth and 5
appeared as teeth with
uniformly pink; cavities, no
moist, soft, more
glistening and abnormalities
with elastic noted.
texture.
The tongue of the
client is
centrally
positioned. It is
pink in color,
moist and
slightly rough.
There is a
presence of thin
whitish coating.
The smooth
palates are light
pink and smooth
while the hard
palate has a more
irregular
texture.
The uvula of the
client is
positioned in the
midline of the
soft palate.
The neck
muscles are equal
in size. The
client showed
coordinated,
smooth head
movement with no
NECK discomfort. Symmetrical, no Normal findings
The lymph nodules
nodes of the palpated.
client are not
palpable.
The trachea
is placed in the
midline of the
neck.
The thyroid
gland is not
visible on
inspection and
the glands ascend
during swallowing
but are not
visible.
The jugular
veins are not
visible.
There were no
visible
pulsations on the
aortic and
pulmonic areas.
There is no
presence of
heaves or lifts.
EXTREMITIES
Client’s able to
MUSCLE resist force when Firm, no masses Normal findings
STRENGTH strength is palpated.
tested, there is
visible
contraction but
no movement is
noted when arm is
moved against the
direction of pull
in the muscle.
There were no
JOINTS swelling, No tenderness Normal findings
tenderness and palpated
joints move
smoothly.
BACK
Firm and Not
BUTTOCKS soggy Firm and not Normal findings
soggy
2-3 inches
GENITALS Normal in size Normal findings
No foul odor and
ANUS discharges No discharges Normal findings
noted
Clinical laboratory
Hematology Department
Component Reference Range
Red Blood Cells 5.20 4.0-6.0x10^12/L
Haemoglobin Mass 131 Male 140-180
Hematocrit 0.41 0.37-0.57
Leucocyte Count 11.60 4.8-10.8x10^9/L
DIFFERENTIAL COUNT
Segmenters 0.86 0.40 – 0.74
Lymphocytes 0.09 0.19 – 0.48
Monocytes 0.03 0.03 – 0.09
Eosinophils 0.01 – 0.07
Basophils 0.01 – 0.02
Reticulocytes
Platelet Count 341 150 – 450
x10^9/L
CRP Non
Reactive < 6 mg/L
Semi-Quantitative CRP <6
Indices
MCV 82 – 92 ft
78 28 – 32 pg
MCH 32 – 38 %
25 0 – 10 mm/hr
MCHC 5 – 15 mins
32 1 – 7 mins
ESR (Westergen)
8 11 -15 seconds
Clotting Time (Lee and white)
6’00”
Bleeding Time (Ivy’s Method) 22 – 45 seconds
3’00”
COAGULATION STUDIES
Prothrombin time
11.1
PT % Activiy
100
PT INR
0.82
Activated PTT
35.1
LABORATORY RESULT
ABO BLOOD GROUP
Rh Group: B POSITIVE
FINDINGS: