Radiology

How Do Our Bones Heal After a Fracture?

Kerplunk.

Crack.

Waa…Waah!

Broken bones, or fractures, are common in kids. Most fractures heal very well if held in the correct position and protected. So, how do our bodies do that?

Immediately after a fracture occurs, the body protects the injured bone by forming a blood clot which temporary plugs the bone gap. These changes alert our immune system to send inflammatory cells to the injured tissue, which stimulates the healing process.

After 1-2 weeks, the body starts to lay the foundation for bone repair.  New blood vessels run through the blood clot or hematoma—think of them as the roads around a construction site. Multiple types of bone-building cells are also scattered around the fracture site—think of these as the carpenters, plumbers, and electricians.

Now, it’s time to make new bone. Some cells (fibroblasts and chondroblasts) make a framework of tissue in which other cells (osteoblasts) deposit new bone.  New bone starts to grow on both sides of the fracture line and progressively grows together forming a callus which closes the fracture. This usually takes 1-4 months.

Unfortunately, this callus is not strong enough to withstand the repetitive stress we place on our bodies. Remodeling of the callus takes place over a period of time, restoring the normal bone structure. Depending upon the type of fracture, this remodeling process can take up to a year.

Below, there are several images of a displaced fracture through the femur. The bone breaks and moves, and the two pieces are not lined up straight. The blood clot surrounding the new fracture (Day 1 and 1 week) is not well seen.  See how new bone forms around the fracture (1 month and 6 weeks) and over time is remodeled back into an almost normal appearance (10 months).

Contributed by Dr. Austin Dillard and edited by Janet Adams, (ADV TECH-ULT).

Janet M. Adams

About the Author: Janet M. Adams

Janet is a sonographer at Cincinnati Children’s. She has worked in the Ultrasound department for over 26 years, and clearly has a passion for working with children. Janet serves as a lead Safety Coach, TJC representative, and education resource for her department. She enjoys challenging exams, and is involved in local and global ultrasound research projects. When she is not at work, her 4 children and 9 grandchildren keep her very busy!

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