Evaluation of Healing: Tests of Union
- Clinical: no longer tender to palpation orangulation stress
- XR: trabeculae cross # site, visible callus bridging site
Stages of Bone Healing
|
Time Period |
Biological Response |
|---|---|
|
weeks 0-3 |
hematoma, macrophages surround # site |
|
week 3-6 |
osteoclasts remove sharp edges, callus forms within hematoma |
|
weeks 6-12 |
bone forms within the callus, bridging fragments |
|
months 6-12 |
cortical gap is bridged by bone |
|
years 1-2 |
normal architecture is achieved through remodeling |
|
Risk Factors for Non-union |
|---|
|
* smoking |
|
* indolent infection |
|
* inadequate immobilization |
|
* malnutrition |
|
* NSAID use |
|
* # in bone with tenuous blood supply |