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Mu1 - Normal bone healing; Adv & Dis of each type (Tissues in bone…
Mu1 - Normal bone healing; Adv & Dis of each type
Bone healing
Fractures disrupt bone continuity
Load bearing & muscle contraction
Fracture displacement
Load transmission not possible
Clinical Signs
Loss function
Swelling
Change length, alignment, orientation
Limb shorter
Major bones involved
Abnormal ROM (R>I)
Pain
Creptius
Healing requirement
Reduction & stability
Vascularisation
Protect cells in gap
Absence complicating factors
Time
Tissues in bone healing
Progression of cell invasion
Haematoma
Granulation tissue
Vascular invasion
Fibroblast differential & invasion
Fibrocartilage
Mineralisation
Healing under limited motion
Callus formation
Progressive increase stiffness of fracture gap
Remodelling phase restores normal architecture
Primary bone union
Complete stability
No/Small gap
Achieved by intefragmentary compression
Closes gaps present
Increases stability
Contact healing
Direct apposition
Direct remodelling
New cutting cones at fracture
Reduced radiographic density at bone ends
Gap healing
Small gaps between fracture ends
Minimal movement
Lamellar bone forms in gap
Intracortical remodelling through gap
Restores bone integrity
No benefit from primary over callus
Slower healing
Gains strength slower
Most benefits arise from rigid stabilisation
Early return function
Reduced risk fracture disease
