Bones , Fracture and Fracture Healing


What are the function of bones in our body ?

Bones are important organs to provide shape, support and structure of the body.They also facilitate

movements.

They provide a large stock of some minerals in our body.

Bone marrow produces blood cells.


How is bone formed  ?

Bone composition

Cells , Extracellular matrix and lipids. 20 % is water.

65-70 % dry weight consists of inorganic substances and 30-35 % is organic substances.


What are different types of cells in the bone ?

These are Osteoblasts , Osteoclasts and Osteocytes.


Bone development embrologically

 Intramembranous , Cartilginous model or both .

Intramembranous bone forms without cartilage model. All Flat bones and Clavicle .

Cartilaginous Model - All long  bones except Clavicle .




What are types of bones ?

Spongy bone and Cortical(compact ) bone



What are different classification for fractures ?

A.Based on Shape of fragments

1.Transverse           2.Oblique     3.Spiral            4.Communited


B.Based on etiology

1. Traumatic           2. Fatigue     3.Pthological


C.Based on wounds

1.Close Fractures                 2.Open or Compuound fractures



C.Other classification

1. Compression /Crush fracture   2.Gunshot fractures

Fracture analogy

 Green-stick fracutre - Fracuture pattern in young children less than 10 years old analogus to green

woods which fracture on outside when bent .


What are stages of fracture healing ?

1. Stage of Inflammation

2. Stage of Proliferation

3. Stage of Remodelling



How to classify Fracture healing ?

Primary (Direct ) Healing - occurs with intramembranous bone formation.No visible callus seen.e.g. Fracture with anatomically reduction and fixed rigidly(e.g. DCP, locking plate,TBW,External fixator) heal by this way.

Secondary (Indirect ) Healing -Heal with cartilaginous model.Callus forms during bone formation.e.g. Healing with nail fixation where there will be micromotion.



What happens in remodelling phase  ?

Irregular woven bones convert into lamellar bone. It may take upto 7 years.


How is fracture healing evaluation done ?

Non invasive techniques

  no pain at fracture site , no bony tenderness , ability to weight bear

   X-ray and CT scan

Invasive techniques

  Macroscopic and microscopic techniques,tensile loading , biochemistry and molecular methods.

In practice almost always non-invasive techniques are used .



for more information for medical students see
orthonp.blogspot.com

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