it consist of fracture its types and the process of bone healing. easy to understand for the students with the help of images.

1. Fractures and
Bone Healing
MS. BHARTI SHARMA
M.SC NURSING
BEE ENN COLLEGE OF
NURSING, JAMMU.

2. Response to Mechanical Stress
 Wolff’s law – a bone grows or remodels in
response to the forces or demands placed
upon it
 Observations supporting Wolff’s law
include
 Long bones are thickest midway along the
shaft (where bending stress is greatest)
 Curved bones are thickest where they are
most likely to buckle

3. Statistics
 Fractures of extremities most common
 More common in men up to 45 years of age
 More common in women over 45 years of age
 Before 75 years wrist fractures (Colles’) most
common
 After 75 years hip fractures most common

4. 4
Fractures
A fracture is any break in a bone.
 Fracture repair involves formation of a clot called
a fracture hematoma, organization of the
fracture hematoma into granulation tissue called
a procallus (subsequently transformed into a
fibrocartilaginous [soft] callus), conversion of the
fibrocartilaginous callus into the spongy bone of
a bony (hard) callus, and, finally, remodeling of
the callus to nearly original form.

5. Common Types of Fractures

6. Common Types of Fractures

7. Common Types of Fractures

8. 8
Common Types of Fractures
 Named for shape or position of fracture line
 Common types of fracture
 Pott’s -- distal fibular fracture
 Colles’s -- distal radial fracture

9. Transverse fracture
 Usually caused by directly applied force to
fracture site

10. 10
Repair/Healing of Bone
 Healing is faster in bone than in cartilage due to
lack of blood vessels in cartilage
 Healing of bone is still slow process due to
vessel damage
 Clinical treatment
 closed reduction = restore pieces to normal position
by manipulation
 open reduction = realignment during surgery

11. Fracture Fixation
 4-12 weeks
 External fixation
 Internal fixation
 Intermedually nails, compression plates
 Frame fixation

12. External fixation
 Used for fractures that are too unstable for
a cast. You can shower and use the hand
gently with the external fixator in place.

13. Frame fixation
 Allows correction of deformities by moving
the pins in relation to the frame.

14. Internal fixation

15. 15
Repair of
a
Fracture

16. Stages in the Healing of a Bone
Fracture
 Hematoma
formation
 Torn blood vessels
hemorrhage
 A mass of clotted
blood (hematoma)
forms at the
fracture site
 Site becomes
swollen, painful,
and inflamed
 3-4 hours
1
Hematoma
Hematoma formation

17. Stages in the Healing of a Bone
Fracture
 The fibrocartilaginous callus forms when:
 Osteoblasts and fibroblasts migrate to the
fracture and begin reconstructing the bone
 Fibroblasts secrete collagen fibers that
connect broken bone ends
 Osteoblasts begin forming spongy bone
 Osteoblasts furthest from capillaries secrete
an externally bulging cartilaginous matrix that
later calcifies

18.  Fibrocartilaginous
callus forms
 Granulation tissue
(soft callus) forms
a few days after
the fracture
 Capillaries grow
into the tissue and
phagocytic cells
begin cleaning
debris 2 Fibrocartilaginous
callus formation
External
callus
New
blood
vessels
Spongy
bone
trabeculae
Internal
callus
(fibrous
tissue and
cartilage)

19.  Bony callus formation
 New bone trabeculae
appear in the
fibrocartilaginous callus
 Fibrocartilaginous callus
converts into a bony
(hard) callus
 Bone callus begins 3-4
weeks after injury, and
continues until firm union
is formed 2-3 months
later
3 Bony callus
formation
Bony
callus of
spongy
bone

20.  Bone remodeling
 Excess material on
the bone shaft
exterior and in the
medullary canal is
removed
 Compact bone is
laid down to
reconstruct shaft
walls 4 Bone remodeling
Healing
fracture