# 14 YO Girl Admitted with a Broken Leg History: Nicole Michaelson, a 14-year-old girl, was skiing...

###### Question:

14 YO Girl Admitted with a Broken Leg History: Nicole Michaelson, a 14-year-old girl, was skiing when she fell and broke her left leg. As she fell, her left leg got caught under the body of another skier who ran into her. An X-ray revealed that the fracture was a compound, tibial-fibular fracture just below the knee. The X-ray also revealed a torn meniscal cartilage in the knee above the fracture. The girl remained in the hospital for 14 days because of an infection of the leg in the area of skin breakage. Her immobilized leg was casted after the infection subsided. She remained in a full leg. length cast for 3 months, after which the upper portion of the cast was removed and she was allowed to start bearing weight on the leg. The bones ultimately healed, but the girl continued to have left knee swelling ("water on the knee") and pain made worse by walking. Arthroscopic examination of the knee revealed a meniscus that was still torn 6 months after her injury. 1. Why was her injury more likely to become infected than a routine fracture of the leg? 2. How does weight-bearing influence the bone repair process you described above? (i.e. what effect does weight-bearing have on the orientation of the Haversian systems?) 3. Why did Nicole's bones heal much more quickly than her cartilage?

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