The natural process of healing a fracture starts when the injured bone and surrounding tissues bleed, forming a fracture hematoma. The blood coagulates to form a blood clot situated between the broken fragments. Within a few days, blood vessels grow into the jelly-like matrix of the blood clot. The new blood vessels bring phagocytes to the area, which gradually remove the non-viable material. The blood vessels also bring fibroblasts in the walls of the vessels and these multiply and produce collagen fibres. In this way the blood clot is replaced by a matrix of collagen. Collagen's rubbery consistency allows bone fragments to move only a small amount unless severe or persistent force is applied. At this stage, some of the fibroblasts begin to
i. When discussing osteoporosis, the bones that automatically come to mind are the wrist, spine, and hip. Certain parts of the vertebral column are also common osteoporotic bones. In the vertebral column, the upper lumbar, lower thoracic, and cervical vertebrae are usually the bones that end up becoming osteoporotic.
The fracture seen in the images is called a comminuted fracture and is seen on the proximal end of the humerus. A comminuted fracture Is identified by the bone being spit into multiple fragments. As seen in the images provided the humeral head is seen with 2 fragments coming off of the medial and lateral aspects. Due to the multiple fragments as well as the patients MOI I deemed this fracture comminuted. The etiology for a comminuted fracture is described as an extreme pressure being exerted on a bone1. This matches the MOI of the patient who claimed that she fell onto her shoulder after slipping on the ice. The extreme pressure would be her entire body weight being exerted onto her humeral head during the fall and with her decreased bone density
Medline Plus defines a traumatic fracture as a trauma sustained by a fall or an auto accident; also known as a broken bone, this is when the bone cracks or breaks during a high impact situation. The traumatic fracture can also be stress fractures where the bone breaks due to overuse whereas a compound or open fracture tend to cut through the skin. Compound fractures, unlike a closed or simple fracture which is hard to see because it does not protrude through the surface. But one of the most misunderstood fractures is the sacral fracture located at the bottom of the spine its noted on Orthobullets website as being a fracture resulting from a neurologic compromise that affects both the elderly and young adults alike. While pathologic fractures
How does osteoblast assist when recovering from a fractured bone? When a bone breaks osteoblast lay down the mineral bone matter (calcium salts) and osteoclasts removes excess bone debris (smooth out the bone).
Bones is a living tissue that contain a blood vessel and nerves. It capable of moulding itself when it damaged.
These fractures are one of the major causes of morbidity, mortality, decreased quality of life and impairment in men and women. The fractures of the hip are of major public health concern, because it puts the burden on both social cost and health condition. In each year approximately 200 million people in the world are affected by osteoporosis and 8.9 million fractures occur around the
As a results of osteoclast death, the remodeling site becomes free of osteoclasts (Del Fattore , Teti ,and Rucci 2008). Phase 3: osteoblast precursors proliferate and differentiate at the remodeling site and start synthesizing new collagen matrix (Wilson 2011). They also initiate matrix mineralization by releasing small matrix vehicles which include Ca and phosphate and ALP (Anderson 2003). Additionally, the osteoblasts produce different factors that are stored within the newly synthesized bone for future use and released during subsequent remodelling cycles (Kang 2012). Phase 4: As bone formation persists, osteoblasts be come entrenched more deeply into the bone and eventually become surrounded by bone and are
Bone remodeling is a five-stage process. Bone is renewed to prevent accumulation of micro-damage and maintain bone strength and BMD (Burr,
If ultrasound therapy is applied during the inflammation phase,the total amount of time in this phase is reduced (Haar, 1999). During the proliferative phase,cells rapidly divide in the area, and collagen is synthesized resulting in healing of the tissue withscar tissue. Ultrasound therapy during this phase stimulates the fibroblasts to create collagen at aquicker rate, and the resulting scar tissue is more pliable than scar tissue that wasn’t treated withultrasound therapy (Haar, 1999). Ultrasound therapy even increases the chances for skin grafts tobe accepted and become living tissue.Bone injuries also can benefit from ultrasound therapy tremendously. Bone repair healssimilarly to soft tissue damage, following the same pattern. During the inflammation andproliferative phases, ultrasound therapy quickens the healing process. However, people must becautious of the timing of ultrasound therapy, because during the late proliferative phase,ultrasound therapy actually hinders the healing process. The mechanisms are not exactly known,but it interrupts the calcification of the broken bones coming together (Haar, 1999).Ultrasound Application ProcessThe first step to the application process is ensuring that the application area is clean anddry, then applying a gel matrix to the head of the ultrasound transducer (the head that generatesthe sound waves). The healthcare provider should move the transducer in a circular stroke, with½ of the previous
Elliott, Hankins, Harris, Perkins, Rosenbaum, & Toole used eleven patients who were over 60 years old who had recently fallen and broken their ankles (Elliott et al, 2015). The fractures being studied are open fractures. All of the test subjects were chosen in a ten year span from 2004 to 2014. All but two of the patients had diabetes prior to the fracture and eight out of the eleven also had other chronic illnesses (Elliott et al., 2015). There were three male and eight female patients (Elliott et al., 2015). All of the patients were treated by the same surgeons in the same facility (Elliott et al., 2015).
Quadriplegia is a very complex, life-threatening condition that requires immediate attention after initial injury. After arriving at the hospital, focus on survival is key by monitoring the airway. Respiratory support may be required via mechanical ventilation through a noninvasive intermittent positive pressure ventilator or an invasive tracheostomy if the injury has affected the individual’s diaphragm. After the airway is patent, the regaining of vertebral alignment and immobilization of the spinal fracture site is implemented to reduce further damage to the spinal cord. Diagnosing a SCI is based on a physical examination, neurological evaluation, and diagnostic imaging to assess the extent of damage. Stabilization of the fracture
Tissue healing is the inherent ability in our body to restore the disruption of tissue structure and function after physical injury. This healing process is natural restorative responses in our body like a complex cascade of overlapping cellular events which usually are described separately for simplified explanation but in reality form a continuum (Diegelmann and Evans, 2004). The process starts immediately after an injury and may continue for months or years, depends on the cause of the injury and contributing factors like the type of tissue damaged, differences in location, severity, and the coverage of destroyed tissue.
Bone remodeling requires discarding of mineralized bones by the osteoclasts followed by emergence of bone matrix from osteoblast that in due course becomes mineralized.
Stress Fractures Treatment of a stress fracture is based primarily on moderation and rehabilitation. Once diagnosed, the injured area should be relieved of as much stress as possible through varied means such as a walking boot or crutches. If the affected region is not permitted to rest the injury may intensify with activity and daily activities, causing extensive and complicated issues. If swelling is present, ice can help in the reduction of the discomfort which often presents itself as intense pressure in a concentrated region (Oakes). Anti-inflammatory medications can also be taken to reduce the swelling and allow the blood to flow more easily. Rehabilitation should begin after the initial injury phase and should include target work outs
Fibroblasts and osteoblasts enter the area of the blood clot and begin to reform bone. Fibroblasts are cells that pronounce connective tissues, while osteoblasts secrete the matrix for bone formation. Fibroblasts produce collagen that connect the ends of broken bone together while the osteoblasts start to form new spongy bone. The connective tissue between the ends of the bone is called the fibrocartilaginous callus. (“Bone Remodeling and Repair” boundless.com) This callus of hyaline and fibrous cartilage acts as a splint for the fracture. This phase is called the bone generation/soft callus formation phase. (“Anatomical Kinesiology: Types of Fractures, healing, and clinical advances in bone repair.”