This chapter focuses on the purpose and composition of the skeleton, bones, and bone tissue, and their formation and maturation. Providing the basis for understanding the inherent weaknesses and susceptibility of the immature infant skeleton to physical injury, this information also builds the foundation for comprehending the morphologic expression of the trauma and the body’s response to the associated tissue damage. Skeletal structure and function The skeletal system is vital to life. It plays an essential role in mineral metabolism, movement, protection of viscera, endocrine regulation of critical biologic processes (energy metabolism, male phenotype and fertility, ion homeostasis), and the storage and nourishment of hematopoietic marrow. To accommodate these demands the skeletal system is complex and composed of 206 organs, namely, the individual bones of the body, and a variety of different cell and tissue types (Fig. 1.1). Bones are intricate living structures that have the unique capacity to undergo constant remodeling throughout life. This special biology forms the foundation of its growth and development, its ability to change its structure, function, and metabolism in response to biomechanic and systemic requirements, and its remarkable proficiency in repairing itself, often completely, in the setting of skeletal injury (1).
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