Musculoskeletal

Question 1

How are fractures classified? How do fractures heal? What factors impair fracture healing?

Answer 1

1. Classification of fractures
   - Complete/incomplete
   - Open/close
   - Comminuted
   - Displaced
   - Pathologic
   - Stress
2. Fracture healing
   - Hours: Platelets forming hepatoma and fibrin mesh
   - Days: Inflammatory cells influx
   - 1 week: Fibroblast and osteoprogenitor cells laying collagen to form pro-callus, organised hematoma
   - 2-4 weeks: Osteoblasts forming woven bone and bony callus
   - 6 weeks: Bone remodelling and callus maturation
3. Factors impairing fracture healing
   - Inappropriate immobilisation
   - Severe displacement
   - Poor nutrition
   - Reduced blood supply
   - Foreign body
   - Infection
   - Diabetes
   - Osteoporosis