Bone Repair Process

Overview

• Bone repair is a natural process due to the vascular nature of bone tissue.
• Typically takes 4-8 weeks for a bone to heal if set properly.
• Initial step before repair is realignment of bone ends (Step Zero).
  • Realignment involves setting the bone ends correctly.
  • Complicated fractures (e.g., comminuted fractures) may require screws and plates.
  • Proper alignment is crucial for optimal healing.

Steps of Bone Repair

Step 1: Hematoma Formation

• A hematoma is a large mass of clotted blood around the fracture site.
• Causes swelling and pain in the region.

Step 2: Fibrocartilaginous Callus Formation

1. Granulation Tissue Formation
   • Forms a soft callus, serving as a temporary placeholder.
2. Fibroblasts and Osteoblasts Activity
   • Secrete collagen, forming a cartilaginous callus.
   • Hyaline cartilage grows, causing a bulge in the fracture region.

Step 3: Bony Callus Formation

• Spongy bone begins to replace the fibrocartilaginous callus.
• A bony callus is formed, which continues to develop as new bone.

Step 4: Bone Remodeling

• Removal of bony callus over time.
• Compact bone or appropriate bone type replaces the callus.
• Remodeling can take years, and perfect regrowth is not guaranteed.
• Healing prospects are better in younger patients, though some issues may persist regardless of age.

Key Points

• Realignment (Step Zero) is essential for the healing process.
• Each stage of repair is crucial for proper bone healing.
• Bone remodeling is a prolonged process and may not fully restore original bone structure.