Chapter 57: Musculoskeletal System

The chapter details bone healing progression through inflammatory, reparative, and remodeling phases while addressing age-related skeletal changes. Diagnostic methodologies including radiography, magnetic resonance imaging, arthroscopy, arthrocentesis, bone density assessment, biopsy procedures, and electromyography are reviewed with clinical applications. Soft tissue injuries such as muscle strains and ligamentous sprains are presented alongside management protocols including the RICE framework and surgical repair options. Fracture classification encompasses closed and open fractures, comminuted patterns, and pathological fractures, with reduction techniques and internal or external fixation strategies. Traction systems including skin and skeletal varieties with specific applications like Buck's and Russell's methods are explained with emphasis on client safety and pin site management. Casting procedures address application techniques, drying timelines, and monitoring for complications including pressure injuries and infection, supplemented by isometric exercise instruction. Serious postoperative complications including fat embolism presenting with hypoxemia and petechiae, pulmonary embolism with associated dyspnea, compartment syndrome manifesting with pain and paresthesia, osteomyelitis requiring antibiotic therapy, and avascular necrosis from compromised blood supply are discussed with recognition strategies and interventions. Mobility assistance devices and gait training encompass crutch patterns, walker and cane techniques, and stair safety. Joint pathologies including dislocation, subluxation, and herniated intervertebral disks with associated traction and spinal precautions are covered. Arthropathies including rheumatoid arthritis as a systemic autoimmune condition with deformity progression and surgical options like synovectomy and arthroplasty, osteoarthritis as a degenerative process with characteristic nodule formation, osteoporosis with fracture risk and nutritional management, and gout with uric acid metabolism and dietary modification are detailed. The chapter emphasizes amputation care including phantom limb phenomenon, contracture prevention, and prosthetic preparation alongside environmental modifications and fall prevention strategies.