Stages of Bone Healing
Bones with poor blood supply also at risk for avascular necrossi and non-union.
For example, the femoral head/neck, scaphoid, and talus. This is because much of these bones are encased in cartilige which does not allow vessels to pass through.
Factors that Promote Bone Healing
Factors that Delay Bone Healing
Poor blood supply
Lack of Calcium
Lack of Vitamin D
Excessive bone gap
Microfracture resulting from repetitive sub-threshold loading that ultimately exceeds the bone's intrinsic ability to repair itself.
Often impact sports.
Inflammation of the connective tissue covering the bone surface; the periosteum. This is highly pain sensitive as it has significant nerve and vascular supply.
Most common in tibia = shin splints (anterior tibia)
Immediate Assessment of Bone Injury
You need to ask whether the fracture you are dealing with is potentially life-threatening or limb-threatening.
Ottawa Ankle Rules
The guideline to aid in deciding when to use x-ray for injuries to the ankle.
A permanent failure of healing following a broken bone. This is a serious complication of a fracture.
Often due to avascular necrosis, the two ends are not fixed (next to each other), or infection.
Occurs when a fractured bone doesn't heal properly. It may heal twisted, shorter, or bent.