fracture healing ppt
TRANSCRIPT
![Page 1: Fracture Healing Ppt](https://reader034.vdocuments.site/reader034/viewer/2022052219/577c7d011a28abe0549cf519/html5/thumbnails/1.jpg)
Fracture Healing
![Page 2: Fracture Healing Ppt](https://reader034.vdocuments.site/reader034/viewer/2022052219/577c7d011a28abe0549cf519/html5/thumbnails/2.jpg)
There are two type of healing :1. Healing by calus (natural)2. Healing by direct union
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Healing by Calus
1. Tissue destruction and haematoma formation
2. Inflamation and cellular proliferation3. Callus formation4. Consolidation5. Remodelling
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Hematoma Formation (1st)
• Vessel are torn • Hematoma forms in medullary canal and
surrounding soft tissue • Bone at the fracture surface deprived of a
blood supply, dies back for a millimeter or two
![Page 5: Fracture Healing Ppt](https://reader034.vdocuments.site/reader034/viewer/2022052219/577c7d011a28abe0549cf519/html5/thumbnails/5.jpg)
Hematoma Form. continues
• Dead bone and tissue = inflammatory reaction including vasodilation, plasma exudate, and inflammatory cells
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Inflamation and cellular proliferation (2rd)
• First 8 hours (acute inflamation) proliferation and differentiation of mesenchymal stem cells the fragment ends surrounded by cellular tissue creates a scaffold across the fracture site by cytokines and growth factor
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Cellular Formation Phase(2nd)
Acidic environment but turning neutral
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Callus Formation Phase (3rd)
• Fibroblast deposit collagen in the granulation tissue
• Stem cell provide chondrogenic and osteogenic cell
• Soft Callus is formed (woven bone) about 4 weeks the become “unites”
• Osteoclast (derived from new blood vesels) act to mop up dead bone.
![Page 9: Fracture Healing Ppt](https://reader034.vdocuments.site/reader034/viewer/2022052219/577c7d011a28abe0549cf519/html5/thumbnails/9.jpg)
• Internal callus (grows quickly to create rigid immobilization)
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Callus Phase continued
• Hard callus – a gradual connection of bone filament to the woven bone that becomes more densely mineralized (Acts like a temporary splint)
• Bone is beginning to strengthen and immobilize
• If proper immobilization does not occur; cartilage will form instead of bone
![Page 11: Fracture Healing Ppt](https://reader034.vdocuments.site/reader034/viewer/2022052219/577c7d011a28abe0549cf519/html5/thumbnails/11.jpg)
Consolidation Phase (4th)
• Woven bone Lamellar bone (3-4 months)• Bone ends become crossed with a new
Haversian system that will eventually lead to the laying down of primary bone
• Osteoblasts fill in the remaining gaps between the fragments with new bone
![Page 12: Fracture Healing Ppt](https://reader034.vdocuments.site/reader034/viewer/2022052219/577c7d011a28abe0549cf519/html5/thumbnails/12.jpg)
• Fracture is bridged and united
![Page 13: Fracture Healing Ppt](https://reader034.vdocuments.site/reader034/viewer/2022052219/577c7d011a28abe0549cf519/html5/thumbnails/13.jpg)
Remodeling Phase (5th)
• Remodeling hard callus to compact/solid bone • May take a few years • Completed when the fractured bone has been
restored to its original form or shape or when it can withstand the imposed stresses placed on it
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Conditions that interfere with fracture healing
• Poor blood supply to the fractured area; could lead to avascular or aseptic necrosis
• Poor immobilization of fracture site may cause misalignment or deformity
• Infection – more common with open fractures