Fracture repair

DRAGO MARIJANOVIĆ, 3RD YEAR

24TH OCTOBER 2018
What is fracture repair?
Physiological process in which the body facilitates the repair of a bone fracture
Starts immediately after fracture
Slow due to vessel damage
Clinical treatment
o closed reduction = restore pieces to normal position by manipulation
o open reduction = realignment during surgery
Stages
•Reaction
•Reparation
•Remodelling
 Formation of fracture hematoma
◦ Bleeding from damaged vessels

◦ Blood clotting and formation of

hematoma (callus template)

◦ Inflammation and formation of

granulation tissue

◦ Site becomes swollen, painful, and

inflamed
 The fibrocartilaginous callus formation
Periosteum replicate and transform
◦ Proximal- chondroblasts External
callus
◦ Distal- osteoblasts

Fibroblasts (from granulation tissue)

◦ secrete collagen fibers that connect broken bone ends
◦ transform into chondroblasts
Internal
Collagen + cartilage = internal (soft) callus callus
(fibrous
Woven bone- external callus tissue and
cartilage)
 Bony callus formation
Calcification of woven bone
Endochondral ossification of internal callus
◦ Calcification of hyaline cartilage- bony callus

New vessels and osteoblasts

◦ they penetrate mineralized matrix to form lamellar bone
◦ this new lamellar bone is in the form of trabecular (spongy)
bone
 Remodelling
Trabecular bone is first resorbed by osteoclasts
◦ Howship's lacuna- shallow resorption pit

Osteoblasts deposit compact bone within the

resorption pit
May take 3 to 5 years to complete
Are broken bones stronger after they
heal?
https://www.youtube.com/watch?v=pFTtpkU4UsI
Quiz
What are the stages of bone reparation
•Reaction, Reparation, Remodelling
How do we call shallow resorption pit made by osteoclasts
• Howship's lacuna
How long does remodelling last
•3 to 5 years
Are broken bones stronger after they heal?
•No
References
1. J. Fanghanel, F. Pera, R. Nitch (2009): Waldeyerova anatomija
čovjeka, Golden marketing - Tehnička knjiga
2. L. C. Junqeira, J. Carmeiro (2005): Osnove histologije, Školska knjiga
3. Guyton, Hall (2017): Medical physiology, Elsevier
4. B. Durst- Živković (2007): Praktikum iz histologije, Školska knjiga