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Stages of fracture healing

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The different stages of fracture healing are outlined below:

  • haematoma: there is tissue damage and bleeding at the site of the fracture. There is death of bone for a few millimetres back from the fracture line.
  • inflammation and cellular proliferation: there is an acute inflammatory reaction within 8 hours of the fracture with proliferation of cells under the periosteum and within the breached medullary canal.
  • callus formation: the cell population changes to osteoblasts and osteoclasts; the dead bone is mopped up and there is the appearance of woven bone in the fracture callus.
  • consolidation: lamellar bone replaces woven bone and the fracture is solidly united.
  • remodelling: the crude 'weld' is reshaped by continuous process of alternating bone resorption and formation to resemble the normal structure.

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