Fracture Healing

Question 1

Stages of fracture healing of a cortical bone

Answer 1

Stage of hematoma
Stage of granulation tissue
Stage of callus
Stage of remodeling
Stage of modelling

Question 2

Stage of hematoma

Answer 2

1. Last up to 7 days
2. Formation of hematoma between and around the fracture.
3. Periosteum and local soft tissues are stripped from fracture ends.
4. Esheemic necrosis of fracture end over a variable length.
5. Due to inadequate blood supply some of your sites die whereas others are sensitized.

Question 3

Stage of granulation tissue

Answer 3

1. Last for about two to three weeks.
2. Daughter cells produce cells which differentiate and organise to provide blood vessels, fibroblast ,osteoblast etc
3. This tissue eventually gives a soft tissue Anchorage to the fracture.

Question 4

Stage of callous

Answer 4

1. Last for four to 12 weeks
2. Granulation tissue differentials further and form osteoblast.
3. Cell laydown an intercellular Matrix which soon becomes impregnated with calcium salt. This result in formation of callous, also called woven bone.
4. First sign of union visible on X-rays.

Question 5

Stage of remodeling

Answer 5

Formally called stage of consolidation.
Woven bone is replaced by mature bone with the typical lamellar structure.
The process of changes multicellular unit based where a pocket of caluss is replaced by a pocket of lammelar bone.

Question 5

Stage of remodeling

Answer 5

Formally called stage of consolidation.
Woven bone is replaced by mature bone with the typical lamellar structure.
The process of changes multicellular unit based where a pocket of caluss is replaced by a pocket of lammelar bone.

Question 6

Stage of modelling

Answer 6

Formally called stage of remodelling
Bone is gradually strengthened.
Sharpening of cortices occur at endosteal and periosteal surface.
Major stimulus to this process comes from local bone strains.

Question 7

Primary bond healing

Answer 7

Occurs where fracture hematoma has been disturbed, As in fractures treated operatively.
Bone heals directly without calluss formation.
Difficult to evaluate on X-Ray.

Question 8

Secondary fracture healing

Answer 8

Fracture hematoma not disturbed.
In cases of treated non operatively.
Healing with a calluss formation.
Can be valued on X-rays.
Also in fracture separated without disturbing hematoma, as in fractures fixed with relative stability.

Question 9

Factors affecting fracture healing

Answer 9

1. Age of the patient
2. Type of bone
3. Pattern of fracture
4. Disturbed patho anatomy.
5. Type of reduction
6. Immobilization
7. Open fracture
8. Compression at fracture site