1. Bone Growth & Repair Model Trauma Damage to blood vessels Fibroblasts Start of Callus Osteoblasts Osteoclasts Callus to bone Immature bone Ossification Mature bone

2. Bone Repair Cycle 1.Trauma-Damage to blood vessels

3. Bone Repair Cycle Fibroblasts Start of Callus Osteoblasts

4. Bone Repair Cycle Osteoblasts Stress Osteoclasts

5. Bone Repair Cycle Callus to bone Remodeling

6. Bone Repair Cycle 1.Trauma-Damage to blood vessels 2.Fibroblasts 3.Start of Callus 4.Osteoblasts 5.Stress 6.Osteoclasts 7.Callus to bone

7. Bone Repair Cycle 8. Wolf’s law: a bone will adapt to mechanical stresses and strains by changing size, shape and structure. Therefore once the cast is removed, the bone must be subjected to normal stresses and strains so that the tensile strength can be regained before the healing process is complete.

8. Tissue Response to Trauma

9. Tissue Repair Diagram Trauma Primary Injury Blood, damaged tissue Acute Inflammation Remodeling Atrophy Rehab Secondary Response Repair Phase necrosisHematoma AdequateInadequate Optimal Recovery Return to full activity Less than optimal Recovery Reduced risk of injury Increased risk of injury PainSpasms

10. Tissue Repair 5 signs of injury (AKA: ?????) 1.Red 2.Swelling 3.Heat 4.Pain 5.Loss of function