1st Exam. Part 12. Healing of BONES & Other tissues Flashcards
- break in the continuity in the bone
- Causes: trauma, medical conditions
(osteoporosis, ricketts)
Fractures
Phases of Bone Healing
- Inflammatory
- Reparative
- Remodeling
Inflammatory phase starts as ____ at the fracture site
hematoma
BV would vasoconstrict to prevent blood loss:
Production of inflammatory signals for repair;
Fibrin clot functions as a network for fibroblasts to grow (inflammation to reparative);
Often not observed in
radiography ;
Promotion of angiogenesis and signal start for reparative stage
Inflammatory phase
Phase where organization of hematoma occurs
Reparative phase
Cell differentiation, ;
Endothelial cells will differentiate into
– fibroblast and osteoblasts (high oxygen tension) into
– bone and chondroblast (low oxygen tension) into
– cartilage
Formation of callus (formed
by
- osteogenic cell
- medullary cavity
- endosteum
Hard callus (4-16 wks)
Reparative phase
In reparative phase, the bridge between bone fragments is formed by the ____ __
haversian canal
Callus formation starts at this bone marrow
Medullary Bridging Callus
External callus formation, movement going outside
Periosteal bridging callus
Callus formation which movement is toward each other
Intercortical uniting callus
Resorption of bone occurs if bone formation.
Is no longer necessary
Function of the osteoclasts
Remodeling
Types of Fracture repair
- Primary
- Secondary
Primary CONTACT healings
- bone fragments are apposed
- rigid fixations are necessary
- hairline fractures
takes more time,
direct ossification
Primary GAP healing
Tying the stainless steel wire to fix the fragments together
Not recommended for
several bone fragments
Wires are st need beyond the fracture line
Cerclage wire
pin should serve as foundation where the bone forms a union
Intramedullary Pin (IM PIN)
an external fixator, immobilizes the limb
sling & bandages
use this if the wound fracture is at the HIP or near FEMORAL head
Ehmer’s sling
use this if wound fracture is at the SHOULDER JOINT
Velteau Sling
Complications of Bone Fracture (5)
1) Osteomyelitis
2) Mal-Union
3) Non-Union
4) Delayed Union
5) Antimicrobial culture
- Mucosa, sub mucosa, muscularis externa , serosa
- Serosa should be apposed properly
- Suture should not pass through the lumen for stomach lining due to the possibility of premature dehiscence from the gastric fluids.
Healing of?
healing of TUBULAR organs
- limited regenerative property
- Does not hold sutures very well (interrupted suture pattern is ideal for muscles
- Scarring decreases muscle efficiency
healing of MUSCLES
do NOT incise through this and not the abdominal muscles
linea alba
- increased in scar formation, decreases the function
- Healing should minimize scar formation
- Synovial fluid should be retained due to its nutritious property that could aid in wound healing
healing of TENDONS & LIGAMENTS
- usually found in joints
healing of CARTILAGE
this has a vital role in healing of joint injuries
Synovial fluid
