Fractures and bony healing

Question 1

Types of fractures

Answer 1

• greenstick
• impacted
• intra-articular
• oblique
• spiral
• transverse
• comminuted
• displaced
• compound
• avulsion

Question 2

Primary bony healing

Answer 2

• rigid fixation
• direct and intimate contact
• heals across fracture site
• slow healing
• no callus
• osteoclastic –> osteoblastic

Question 3

Bony Secondary healing

Answer 3

• most common
• Occurs with casting or exteneral fixation
• chondroblast –> fibroblast
• mineralization and bony replacement or cartilage matrix
• callus forms bridge
• more motion –> larger callus

Question 4

3 phases of secondary healing
- inflammation phase

Answer 4

• 1-2 weeks
• fracture hematoma
• neutrophils, macrophages, phagocytes, osteoclasts

Question 5

3 phases of secondary healing: reparative phase

Answer 5

• lasts several months
• chondroblasts/fibroblast lay matrix
• complete when stable

Question 6

remodeling phase of secondary healing

Answer 6

• last months to years
• osteoclastic and osteoblastic activity (Wolffs Law)

Question 7

Bony healing time frame: healing

Answer 7

• type and location dependent
• 6-8 weeks –> months