Fracture and Bone Repair Flashcards
What are some of the main causes of fractures?
Trauma
Stress Fractures
Osteoporotic fractures
Fractures induced by other diseases
What factors does osteoporosis increase? Fracture wise!
Number of atraumatic fractures
Severity of traumatic fractures
What is an open fracture?
A break in the skin and underlying soft tissues leads directly to or communicates with the fracture and its haematoma
What is a closed fracture?
The skin does not break
What are some of the treatments for fractures?
Restore the bone pieces to their natural position and maintain positions while the bone heals
Use of plasters
Surgery
Bone grafting
Tissue engineering
What are some of the preventions for fractures?
Falling is the most important factor in the elderly not osteoporosis
Exercising can help prevent falls
Calcium and Vit D supplementation
Anti-resorptive pharmacoligical therapy
What are the 4 important process needed for a proper bone healing?
Inflammation
Angiogenesis
Cell proliferation
Differentiation
What happens in the anaboloic phase?
Increase in tissue volume
Formation of skeletal and vasculat tissue from stem cells
What happens in the catabolic phase?
Reduction in the volume of callus
cartilage resorption
Secondary bone foremation
Bone remodelling
What happenis in the inflammatory phase?
Hematoma forms!
Platelets express TGF-beta
Inflammatory cells (immune cells) release cytokines- these remove necrotic tissues and promote angiogenesis and initiate repair
Immune cells promote mesenchymal stem cells and endothelial cells
What is the role of Periosteum?
Critical for fracture healing: provides vast majority stem and progenitor cells that will from bone and cartilage
What happens in the Repair stage?
Mesenchymal cell proliferation—> form cartilage in soft callus—> then form bone
—> form bone in hard callus
If the conditions are hypoxic there will be more cartilage formation
Why is angiogenesis an important factor in fracture healing?
Need oxygen to form bone
More vessels > more vessels> more blood so more oxygen
What happens in the remodelling stage?
Bone remodelling
Restoration of the bone shape and mechanical functions
Woven bone to laminar bone
What are some of the biological strtergies to enchance bone repair? ther is local osteogenic materials and systemic biological enhancement(we want more of this method).
Local osteogenic materials: Autologous bone marrow and platelet, peptide signalling molecules, morphogenetic factors (BMPs & Wnt proteins)
Systemic biological enhancement: PTH and sclerostin monoclonal Ab
