1. Bone Repair

2. Bone Fractures 4 Ways to Classify Bone Fractures
The position of the bone ends after fracture
Nondisplaced
Displaced
The completeness of the break
Complete
Incomplete
The orientation of the bone to the long axis
Linear
Transverse
Whether the bone ends penetrate the skin
Closed/ Simple
Open/ Compound

3. Types of Bone Fractures
Nondisplaced
Bone ends retain their normal position
Displaced
Bone ends are out of normal alignment
Complete
Bone is broken all the way through
Incomplete
Bone is not broken all the way through
Linear
Fracture is parallel to the long axis of the bone
Transverse
Fracture is perpendicular to the long axis of the bone
Closed/ simple
Does not penetrate the skin
Open/ compound
Does penetrate the skin

4. In Addition to those 4 Classifications…
Fractures can be described by:
Location of the fracture
External appearance of the fracture
Nature of the break

5. Common Types of Fractures
Table 6.2.1

6. Common Types of Fractures
Table 6.2.2

7. Common Types of Fractures
Table 6.2.3

8. 4 Stages of Bone Fracture Repair
Hematoma Formation
Fibrocartilaginous callus formation
Bony callus formation
Bone remodeling

9. Stages in the Healing of a Bone Fracture

10. First Stage in the Healing of a Bone Fracture
Hematoma Formation
Torn blood vessels hemorrhage
A mass of clotted blood (hematoma) forms at the fracture site
Site becomes swollen, painful, and inflamed
Hematoma 1
Hematoma formation
Figure

11. Second Stage in the Healing of a Bone Fracture
External callus
Fibrocartilaginous callus forms
Granulation tissue (soft callus) forms a few days after the fracture
Capillaries grow into the tissue and phagocytic cells begin cleaning debris
New blood vessels
Internal callus (fibrous tissue and cartilage)
Spongy bone trabeculae 2
Fibrocartilaginous callus formation
Figure

12. Stages in the Healing of a Bone Fracture
The fibrocartilaginous callus forms when:
Osteoblasts and fibroblasts migrate to the fracture and begin reconstructing the bone
Fibroblasts secrete collagen fibers that connect broken bone ends
Osteoblasts begin forming spongy bone
Osteoblasts furthest from capillaries secrete an externally bulging cartilaginous matrix that later calcifies

13. Third Stage in the Healing of a Bone Fracture
Bony callus formation
New bone trabeculae appear in the fibrocartilaginous callus
Fibrocartilaginous callus converts into a bony (hard) callus
Bone callus begins 3-4 weeks after injury, and continues until firm union is formed 2-3 months later
Bony callus of spongy bone 3
Bony callus formation
Figure

14. Fourth Stage in the Healing of a Bone Fracture
Bone remodeling
Excess material on the bone shaft exterior and in the medullary canal is removed
Compact bone is laid down to reconstruct shaft walls
Healing fracture 4
Bone remodeling
Figure