Bone Growth and Fracture Healing Flashcards
Typical phases of bone growth and ossification
Hyaline cartilage -> primary ossicfication (middle) with secondary ossification sites eg epiphyseal plates and apophyses (the protuberances for muscles)
What is a apophysis?
The protuberances for muscles
Spongy bone aka
Cancellous bone, trabecular bone
What are the uses of cortical vs cancellous bone?
Cortical is used for resisting twisting movements, bending and torsion. Laid down circumferentially.
Cancellous bone is like a shock absorber etc. Found within the metaphysis.
Bone is orig. WHat are the 4 stages in repair of fractures?
Inflammation
- fibroblasts, mesenchykal and osetoprogenitor cells
-Angiogenesis
Soft callous
-cartilage
Hard Callous
-cart -> woven bone
Bone remodelling
What can we do in the 4 stages?
Inflammation:
-NSAIDS
-Drain the area if too inflammed(?)
-Give “Buffy coat” basically your own platelets smeared on the affected area -> make it full of growth factors etc. (prime ffor bone development!)
Soft callous
-replace the cartilage/ jump straight to a bone graft… Autogenous (fron your own body better), basically pop it into where the bone was/ use to be to streamline the replacement and regrowth. Allograft (not your own, so synthetic or someone elses -> not as good and risk of disease eg mad cow)
Hard Callous
-bone grafts
Bone remodelling
What is wolfs law?
The characteristicw of how the muscle acts adn reats to mechanical load when it is being replaced and repaired etc. (like the 3 bears, you want enoiiugh to lie down enough bone but not too much that you cause delayed healing
What is “strain”
the external forces put on a healing bone (you want just the right amaount)
What drugs can cause delayed healing?
Warfrin, NSAIDS, steroids, ciprofloxacin, immunosupression
What is dynamisation? What other techniques can you have in delayed union?
It is when you move the bone around to get it to start healing again?
Can also try bone grafts and different fixations.
Non union shows what
Just a failure to heal. Will have instability, callus’s, pain and tenderness. There will be a persistent fracture line and scelrosis.
Diaphysis, metaphysis, epiphysis
Diaphysis = shaft, then metaphysis is where the shaft starts to flare and then the epiphysis is the end of the bone.
