Diaphyseal Healing

o Stage of Healing from Soft Tissue

Osteogenic cells yang berproliferasi dari lapisan dalam periosteum untuk membentuk
external callus dan to a lesser extent from endosteum untuk membentuk internal
callus.
o Stage of Clinical Union
Temporary external and internal callus mengelilingi fracture site dan membentuk
biological glue yang memperkeras saat cartilaginous components dari callus
digantikan dengan tulang melalui osifikasi endokondral.
o Stage of Radiographic Union
Seiring waktu berjalan, the temporary callus digantikan oleh mature lamellar bone.
Pada saat tulang yang belum matang telah digantikan oleh mature lamellar bone dan
tulang sudah kembali ke diameter yang hampir normal, fraktur itu sudah bisa
dikatakan radiographic union.
Metaphyseal Healing
Diawali dengan pembentukan internal atau endosteal callus, walaupun external atau
periosteal callus yang mengelilingi thin shell of cortex juga memegang peran penting.
Karena banyaknya suplai darah pada thin trabeculae dari cancellous bone sehingga
terjadi sedikit necrosis tulang. The Osteogenic repair cells berproliferasi membentuk
primary woven bonedi internal fracture hematoma. Saat telah terjadi Union, fraktur
sudah clinically united. Lalu, woven bone digantikan oleh lamellar bone saat fraktur telah
radiographic united.

SPECIAL FEATUED FRACTURE

Colles Fractures results from fall on an outstretched hand, often in osteoporotic women. The deformed
and painful wrist looks like a dinner fork. The main lesion is a dorsally displaced, dorsally angulated
fracture of distal radius. Treat with close reduction and long arm cast.

Smith Fracture
Smith's fractures are either extra or intraarticular. These fractures are essentially inverted Colle's fracture
since there is apex dorsal angulation. If the fracture is intraarticular, it is called a Barton's fracture.
Monteggia fracture result from direct blow to the ulna (such as on a raised protective arm hit by a
nightstick). There is diaphyseal fracture of the proximal ulna, with anterior dislocation of the radial head.

Galeazzi fracture is the mirror image of the previous one: the distal third of the radius gets the direct
blow and has the fracture, and there is dorsal dislocation of the distal radioulnar joint. In both of these,
the broken bone often requires open reduction and internal fixation, whereasthe dislocated one is
typically handled with closed reduction.