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Fractures and Bone Healing
Fractures and Bone Healing
Bone Healing
H Biology II
Adapted 2014-2015
Response to Mechanical Stress
Wolffs law a bone grows or remodels in
response to the forces or demands placed
upon it
Observations supporting Wolffs law
include
Long bones are thickest midway along the
shaft (where bending stress is greatest)
Curved bones are thickest where they are
most likely to buckle
Response to Mechanical Stress
Trabeculae form along lines of stress
Large, bony projections occur where
heavy, active muscles attach
Response to Mechanical Stress
Statistics
Fractures of extremities most common
More common in men up to 45 years of age
More common in women over 45 years of age
Before 75 years wrist fractures (Colles) most
common
After 75 years hip fractures most common
Fractures
A fracture is any break in a bone.
Fracture repair involves formation of a clot called
a fracture hematoma, organization of the
fracture hematoma into granulation tissue called
a procallus (subsequently transformed into a
fibrocartilaginous [soft] callus), conversion of the
fibrocartilaginous callus into the spongy bone of
a bony (hard) callus, and, finally, remodeling of
the callus to nearly original form.
6
Bone Fractures (Breaks)
Bone fractures are classified by:
The position of the bone ends after fracture
The completeness of the break
The orientation of the bone to the long axis
Whether or not the bones ends penetrate the
skin
Common Types of Fractures
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How to Handle Fractures
Reduction
Open reduction
Allows very accurate reduction
Risk of infection
Usually when internal fixation is needed
Manipulation
Usually with anesthesia
Traction
Fractures or dislocation requiring slow therapy
Fracture Fixation
4-12 weeks
External fixation
Internal fixation
Intermedually nails, compression plates
Frame fixation
External fixation
Used for fractures that are too unstable for
a cast. You can shower and use the hand
gently with the external fixator in place.
Frame fixation
Allows correction of deformities by moving
the pins in relation to the frame.
Internal fixation
Repair of
a
Fracture
33
Stages
Hematoma
in the Healing of a Bone
formation Fracture Hematoma
Torn blood vessels
hemorrhage
A mass of clotted
blood (hematoma)
forms at the
fracture site
Site becomes
swollen, painful,
and inflamed 1 Hematoma formation
3-4 hours
Stages in the Healing of a Bone
Fracture
The fibrocartilaginous callus forms when:
Osteoblasts and fibroblasts migrate to the
fracture and begin reconstructing the bone
Fibroblasts secrete collagen fibers that
connect broken bone ends
Osteoblasts begin forming spongy bone
Osteoblasts furthest from capillaries secrete
an externally bulging cartilaginous matrix that
later calcifies
Stages in the Healing of a Bone
Fibrocartilagino
us callus forms Fracture
External
Granulation callus
tissue (soft
callus) forms a
few days after New
the fracture Internal
blood
vessels
callus
Capillaries grow (fibrous
tissue and Spongy
into the tissue cartilage) bone