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