2. Fracture Healing Flashcards
primary objective of fracture management
promote an early and complete return to function
reduction
v. - process of re-apposing the fracture fragments
n. - precision of apposition of the fracture segments
allows load sharing between the bone and implants
anatomic reconstruction
Biological Fixation
preserves the local fracture environment
=bridging osteosynthesis (external fixation, plates, or intramedullary fixation)
can be closed or open
trend in orthopedic surgery
away from anatomic reconstruction and towards biologic approach
alignment
orientation of the joints proximal and distal to fracture
has a greater impact on function than reduction does
point of fixation/stabalization
distribute forces along the length of the bone and away from the fracture site
the only tissues capable of producing new cells for healing
bone and liver
phases of secondary bone healing
inflammatory
reparative
remodeling
(hematoma - granulation tissue - CT - cartilage - woven/cancellous bone - haversian remodelling)
haversion systems form how?
along the lines of stress
takes a lot of time
primary bone healing
requires plates/screws. Almost perfect anatomic reduction and rigid fixation.
minimal callus formation
- contact healing with direct apposition
- gap healing with gap < 1 mm
contact healing time v. gap healing?
contact takes 2-3x longer
callus expected to be evident in _______ weeks
2-4 weeks
What will also result in some callus formation?
periosteal disruption
bone grafting
usually take from cancellous bone of the grater tubercle of the humerus
(also iliac crest and proximal tibia)
