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Fracture Healing

What is it called when there is a break in a bone? Fracture
What are the structural Components of morphology of long bone? Diaphysis, Epiphysis, metaphysis and epiphyseal plate
What is morphology of long bone? The structure of the bone
What is histology of long bone? The microstructure of the bone
What is the bone growth plate? Epiphyseal plate
What does the cancellous bone provide? Flexibility
What are the spaces in bone? Trabeculae
Degree of porosity is also known as? Density of bone
What does the periosteum cover? The cortex
Fibrous membrane covering consists of 2 layers, what are those layers? Fibrous and osteogenic layer
Endosteum means? Medullary cavity
What are the osteogenic cells responsible for? Regeneration process
What are the main components of histology (microstructure) of long bones? Cells and Fibers
What are the components of ground substances? Water, GAGs, noncollagenous proteins Solid, mineralized
What do lucanae contain? Small spaces with osteocytes
What is organized, cylindrical structural units, concentric lamellae, lucanae and canalicull? Haversian Systems
Concentric lamellae are.... Calcified rings
Spongy bone -Trabeculae contain lacunae and canaliculi More osteocytes
Interstitial Lamellae are? Bony layers that sit between Haversian canals
What connects the haversian’s canals and contains blood, lymph? Volkmann’s canals
What are the main sources for blood supply? Periosteal artery and Nutrient artery
What enters via nutrient foramen and branches out? Nutrient artery
What goes through mitosis, differentiates into osteoblast and is in ther inner osteogenic layer of periosteum? Osteoprogenitor cells
Whatare osteoblasts involved in? Collagen synthesis and bone formation.
Give some information on osteocytes They are surrounded by extracellular matrix, located in lucanae, and connect to creat a highly vascular environment.
Osteoclasts break down and what else do they do? Deossification, located in bony marrow and Howship's lacunae-absorption of dead bones.
What is the relationship between osteoblasts and osteoclasts? Normally equal, maintain and aid in fracture (Fx) healing
bone regeneration and repair means... converting tissue into bone, also known as ossification or osteogenesis.
What does ORIF stand for? Open Reduction Internal Fixation
What are the stages of bone regeneration and repair? Hematoma formation and Inflammation Cellular proliferation and Callus formation Remodeling
Secondary bone healing vs. primary bone healing Secondary-natural bone healing-casted immobilized
Hemotoma formation Each bony end creates a hemotoma and likes to spread to healthy bone and develops within a few hours after fracture
What does a fracture hematoma do? Bleeds a lot, is located at the bone ends and may extend into surrounding areas.
What is the absence of osteocytes from lacunae? (Death @ fracture site) Necrosis
Replicate bone is also known as? Structural framework Regeneration environment
Fracture hematoma: create granulation tissue
Fibrocartilaginous callus leads to: increased strength leads to bony matrix
Mineralization stage 2: depositing of calcium and phosphorous
Divides into 3 phases Early, intermediate, late
Early repair phase needs a stimulus>disruption of periosteum
Proliferation of osteogenic cells stronger callus does not form for a few days
Osteoprogenitor cells travel to the fx site Osteoblasts and condroblasts (lay down cartilage)
Osteoblasts are.... Stimulus for proliferation and Extends out from primary fx site
Pluripotent cells function is to? Turn into a cell that is needed
What is involved in intermediate repair phase? Formation of granulation tissue and fibrocartilaginous callus, Proliferation of osteoblasts,Granulation Tissue
Endothelial budding Branching out of capillaries
What contains cortex, osteogenic cells, endothelial budding, fibrocarilaginous callus is replaced, begins @ sides of Fx site, visible callus formation via x-ray? External Callus
When is the callus formation visible in an x-ray? After 14 days
the internal Callus consists of... Cancellous bone, osteogenic cells and bridges between the bone ends
What describes the hardening of callus, does not have movement between bony ends and the fracture line is still present? Clinical Union
What happens in the late repair phase? Ossification, mineral deposits and solid bony union. (between 14 and 30 days)
During mineralization the soft cancellous bone hardens, bone density is increased and ____ The woven bone is replaced with primary bone
During primary bone formation the excess callus is absorbed, the medullary cavity is reastablished and the Haversian system is restored. Osteoclasts create medullary cavity and the osteoblasts are in the Haversian system
What are the time factors that affect fracture healing? Amount damaged Cell death Displacement Size of bone Blood supply Approximation of sites Age Nutrition
What is another word for set? Reduce
what is the duration of remodeling ? 6-24 weeks
What is involved in remodeling? Resumes normal size, structure, and shape Begins with stability Osteoclastic activity Organization of trabecular structure Osteoclasts and osteoblast
What does ARF stand for? Activation, Resisting and Formation
What kind of abnormal bone healing complication is not direclty related? Extrinsic Complications
What is the build up of pressure within a staff infection and avascular cell death? Compartment syndrome
Osteoporosis, degenerative joint disease and myocytosis are examples of what? Late extrinsic complications
What kind of abnormal bone healing complication is direclty related? Intrinsic complications
What is the failure of the fracture ends to unite? Non Union
How much time must pass before a fracture is truly considered a nonunion? 6 months
Causes of nonunion vascular compromise not enough blood
What happens in nonunion? Prolonged presence of Type III collagen, bone ends become hard and dense, no bridging
How can you help a nonunion fracture? Rebreak to start the healing process again
What is the definition of a delayed union fracture? Solid bony union, but not within normal time frame
What are some bones that may have delayed union because of the duration of healing? Tibia, femur, humerus
What are some causes of delayed union fractures? Infections, medical treatments
What is the union called when bones unite in a an imperfect position? MalUnion
Created by: dmart171
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