Bone specialist in Hyderabad treats bone fractures considering the natural healing process of bones. The healing process occurs in four phases. Dr. Vasudeva Juvvadi explains bone injuries, fractures, and trauma and the four phases of bone healing.
Bone specialists refer to the term Fracture as a broken bone. A bone fracture or a broken bone is a medical condition where the bone is damaged or broken. It is a condition in which the continuity of the bone is lost. At the same time, most of the fractures result from high impact force or stress on your bony structures. A bone fracture may also occur due to certain medical conditions like osteoporosis, a bone disease that weakens your bones.
A bone fracture can damage a bone wholly or partially. It can occur in any bone in your body. A Fracture commonly occurs due to vehicle accidents, sports injuries, or falls and trauma. Osteoporosis makes bone weak and brittle in older people and can and thus leads to bone fractures. Stress fractures are commonly seen in athletes due to overuse of the bones.
Scientifically, a fracture is the structural discontinuity of the bone cortex, with a range of damage to the soft tissues surrounding the broken bone. However, after the bone gets fractured, it starts to heal, often termed secondary healing. It consists of four phases:
- Hematoma formation
- Fibrocartilaginous callus formation
- Bony callus formation
- Bone remodeling
Failed or delayed fracture healing is seen in around 10% of all fractures and can be caused due to several factors, including infection, bone loss, tumor, and vascular supply damage. In this article, let’s discuss each phase of fracture healing in detail.
A fractured or broken bone undergoes the following four stages:
This stage begins promptly after the fracture. The blood vessels supplying blood to the bone get damaged during the fracture. As a result, a hematoma (blood clot) is formed at the site of the fracture. The hematoma clots the blood at the bone’s broken ends and creates a framework for subsequent healing and is the first stage of the healing process.
Within days after fracture, the capillaries develop within the hematoma, while phagocytic cells start to eliminate the dead cells. Though particles of the blood clot persist, fibroblasts and osteoblasts – biological cells that manufacture the extracellular matrix to stimulate the structural framework, reform bone.
Fibroblasts generate collagen fibers, which help in joining the broken bone ends. Osteoblasts form spongy bone. The sponge acts like restoration tissue between the ends of the broken bone. The fibrocartilaginous callus comprises both hyaline cartilage and fibrocartilage. Some bone spicules(a type of small cells) may also appear in forming the new bone matrix.
Bony Callus Formation
The cartilaginous callus is then transformed into a bony callus. It takes around two months to connect the broken ends’ bones to join firmly after the fracture. This process is similar to endochondral ossification, a systematic approach to restoring the growing cartilage that helps to form the skeleton.
In this phase, the chondroblasts, osteoblasts, and osteoclasts undergo further differentiation. In the end, a hard, calcified callus of immature bone is formed.
The migration of osteoblasts and osteoclasts is continued until the hard callus undergoes remodeling repeatedly, often termed as ‘coupled remodeling.’ This ‘coupled remodeling’ maintains the balance of resorption by osteoclasts and new bone formation by osteoblasts.
The callus is replaced over time by compact bone, while the edges of the callus replaced by mature bone(lamellar bone). Substantial restoration of vascular structures also takes place alongside these changes. The bone remodeling phase continues for many months based on the type of fracture. Ultimately, it results in the reconstruction of the standard bony structure.
Read: Life After A Fracture
Bone specialist treats the fracture and then allow the fracture to heal naturally. To heal the fracture to a substantial degree, physical therapy, exercises are recommended during the rehab process. They help to boost the healing process, improves muscle strength and range of motion.
Many factors affect the healing process of fracture and stimulation methods of fracture healing. However, they can be overcome by proper treatment options. If you face any problems with your broken arm or a fractured leg, consult Dr. Vasudeva Juvvadi, one of the best bone specialist in Hyderabad.