Bone Healing Flashcards

0
Q

What does haematoma formation do?

A

Initiates bone healing. Clotting factors initiate fibrin meshwork, acting as a framework for the growth of fibroblasts and capillary buds.

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1
Q

Name the four stages of bone healing in order.

A
  • haematoma formation
  • fibrocartilaginous callus development
  • ossification
  • remodelling
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2
Q

During haematoma formation, migrating inflammatory cells and platelets do what?

A

Release growth factors which stimulate osteoclast and osteoblast proliferation.

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3
Q

1-2 days post #. Explain:

A

Haematoma begins to form from torn blood vessels in the periosteum and surrounding tissues.

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4
Q

2-5 days post #. Explain:

A

Haemorrhage forms a large blood clot. By day 7 most of the clot is organised by invasion of blood vessels and early fibrosis.

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5
Q

After the first week, bone formation begins. What stage is this apart of?

A

Fibrocartilaginous callus development.

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6
Q

Explain fibrocartilaginous callus development.

A

Fibroblasts and osteoclasts migrate into the # site and begin to reconstruct the bone. A fibrocartilage “collar” forms to connect the bone segments.

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7
Q

Explain the role of fibroblasts in the second stage of bone healing.

A

Produce collagen to connect the bone ends and secrete a collagen matrix.

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8
Q

Explain osteoblasts in the second stage of bone healing.

A

Begin to deposit bone into the matrix.

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9
Q

Wen does ossification begin?

A

3-4 weeks of the # healing.

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10
Q

Is it safe to remove the cast during the ossification stage?

A

Yes, it is usually safe. The # site feels firm and immovable and appears united on an x-ray.

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11
Q

Explain ossification.

A

Mineral salts are deposited into the callus, and mature bone gradually replaces the fibrocartilage callus. Any excess callus is reabsorbed by osteoclasts.

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12
Q

What is the final stage of bone healing?

A

Remodelling.

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13
Q

Explain remodelling.

A

Medullary cavity is restored. The callus matures and transmits weight bearing forces. Excess bony callus that develops in the marrow space and encircles the outside of the # site is reabsorbed.

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14
Q

Name three things fracture complications are due too.

A
  • loss of skeletal continuity
  • injury from bone fragments
  • pressure from swelling and haemorrhage (# blisters, compartment syndrome)
  • involvement of nerve fibres
  • development of fat emboli
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15
Q

Name four things healing time depends on.

A
  • the site of the #
  • the condition of the # fragments
  • haematoma formation
  • local and host factors
  • type of fracture (# of long bone, displaced and a # with less surface area heal slower)
  • age of person
16
Q

Why does age affect healing time? What are the healing time frames for children, adolescents, and adults?

A

The older you are the longer it takes for your bones to heal, because the healing process slows down.

Children: 4-6 weeks
Adolescents: 6-8 weeks
Adults: 10-18 weeks

17
Q

Name four things that can impair bone healing, NOT including age.

A
  • poor nutrition
  • circulatory problems and coagulation
  • local stress around the # site
  • debilitating diseases (RA, diabetes)
  • current medication
  • age
18
Q

Name five factors that can affect bone healing.

A
  • nature of the injury
  • degree of fibrocartilage bridge formation
  • amount of bone loss
  • type of bone injured
  • degree of immobilisation achieved
  • local infection
  • local malignancy
  • bone necrosis
19
Q

Explain the difference between the three following things:

  • malunion
  • delayed union
  • non-union
A

Malunion: healing with deformity, angulation or rotation (does not heal in position)
Delayed union: failure of the # to unite within normal period (does not heal in time)
Non-union: failure to produce union and cessation of the bone repair process (does not heal)