A body’s response to a fracture is important as this decides how effective and fast the healing will be. Though bone healing is a natural process, medical assessment by an experienced orthopedic specialist is important. This is because if broken bones are not re-aligned to their correct anatomies, improper healing will occur. That will result in malunion. In such cases, surgery will be required and that could be complicated. Orthopedic surgeries often involve the use of orthopaedic implants and instruments. 

Well, this article will look into how a fracture heals along with the stages that take place. The method of healing opted for by our body depends on the severity and the type of fracture. 

Healing of Fracture – How Does this Occur?

A fracture heals in one of two ways primary or secondary. Primary healing is not common whereas secondary healing is more common. Let us see how and why.

Primary Fracture Healing

For primary fracture healing to occur, the fracture must be stable with no gaps between fractured bone fragments. This type of healing is not common because not many fractures can be reduced in the correct anatomy along with stability. Hence, primary healing occurs in very few cases.

This process only requires remodeling of the fracture along with surrounding blood vessels. This is because the fracture is already stable, and no gap filling is required. Thus, there will be no callus formation. Primary fracture healing may take a few months to several years. In this healing process, only the remodeling of lamellar bone along with the Haversian canals and blood vessels.

Secondary Fracture Healing

Secondary fracture healing takes place when the fracture requires the application of a cast or orthopedic implants. This is because secondary healing occurs when the fracture cannot be reduced in a stable form and there is a gap between the broken bone fragments. A callus also forms in this healing process. Let us see three stages of secondary bone healing:

The Inflammatory Phase

In this phase, the body immediately responds to fracture, and to stop bleeding, the blood vessels constrict. After this, a clot from the extravascular blood forms around the fracture site to stabilize it and create a framework for new bone formation. 

The Repair Phase

In the repair phase, fibrous tissue and cartilage develop in place of clots. This is known as a soft callus. With progressive healing, the soft callus becomes hard as a hard bone forms. In this stage, a woven bone is formed and gaps between broken bone fragments are filled. 

Bone Remodeling

This is the last phase of bone healing where the newly formed bone becomes compact. With this, the bone also regains its original shape whereas blood circulation improves. Here, the substitution of trabecular bone with compact bone occurs. The phase starts 3-4 weeks after the fracture and may last for as long as 3-5 years. In some cases, synthetic injectable biomaterials may be injected for bone healing. Such biomaterials have osteoconductive properties. 

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