Healing of bone fracture- general pathology

Healing of bone fracture

1. FRACTURE HEALING
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2. HEALING IN SPECIALIZED TISSUE
Fracture::
-Complete, Incomplete #
-Simple, Compound, Comminuted #
-Pathological #
-Stress #
- Green Stick # in Children
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4. STAGES OF FRACTURE HEALING


1. Hematoma formation
2. Traumatic Inflammation
3. Formation Of Granulation Tissue
4. Woven bone And Cartilage Formation
5. Formation Of Lamellar Bone
6. Remodeling


Bone repair is a highly regulated process
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5. Healing in Bone:
1D - Hematoma formation (fibrin mesh)
3D - Inflammation – PDGF, IL, TGF
1W - Soft callus – granulation, matrix.
3-6W - Callus – ossification, woven bone
8+W - Re-modeling – absorb/deposit,
strength, lamellate.
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6. FRACTURE HEALING
Hematoma
Granulation tissue
Cells, mediators, osteo-progenitor cells.
End of 1
st
week:: Organizing Hematoma.
Soft tissue callus or Procallus formation
Mesenchymal tissue deposition &
differentiation into Fibro cartilage or
Hyaline cartilage.
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7. FRACTURE HEALING contd..
Woven bone formation
Repair tissue has maximum girth at 2- 3
rd

week.
Enchondral ossification continues
Fractures ends are bridged by Bony Callus
Excess callus is trimmed
Medullary cavity is restored

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10. REMODELLING
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11. Callus – Woven bone
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12. Callus – Woven bone
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14. FRACTURE HEALING - COMPLICATIONS
Non-Union
Mal-Union
Delayed Union
False Joint or Pseudoarthrosis
Joint Ankylosis
Involucrum Formation
Infections:: Osteomyelitis.
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15. Involucrum
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16. Thank You
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