Fracture healing

John Houlton

doi:10.22233/9781910443279.5

Fracture healing

British Small Animal Veterinary Association , 32 (2016); https://doi.org/10.22233/9781910443279.5

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Fracture healing

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Author: John Houlton
From: BSAVA Manual of Canine and Feline Fracture Repair and Management
Item: Chapter 5, pp 32 - 36
DOI: 10.22233/9781910443279.5
Copyright: © 2016 British Small Animal Veterinary Association
Publication Date: January 2016

Abstract

Bone healing is unusual because the repair tissue is similar to the original tissue: bone rather than scar tissue is formed. Regeneration may be a better term than repair. The rational basis for fracture treatment is the interaction between three elements: the cell biology of bone regeneration, the revascularization of injured bone by the surrounding soft tissues, and the mechanical environment of the fracture. The surgeon should be aware of, and consider, the interaction between these elements when choosing the optimal treatment of a clinical patient. This chapter reviews direct bone healing; indirect bone healing; mechanical manipulation of fracture healing.

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Figures

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5.1

Bilateral femoral fractures in a Labrador Retriever. (a) Left leg. (b) Right leg. When the major fracture fragments have been realigned, the oblique fracture has higher strain conditions than the comminuted fracture due to the shorter length of its fracture gap. © 2016 British Small Animal Veterinary Association

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5.1 Bilateral femoral fractures in a Labrador Retriever. (a) Left leg. (b) Right leg. When the major fracture fragments have been realigned, the oblique fracture has higher strain conditions than the comminuted fracture due to the shorter length of its fracture gap.

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5.2

Histological appearance of direct cortical bone healing. The areas of dead and damaged bone are replaced internally by Haversian remodelling. The fracture line has been graphically enhanced. (Reproduced from Perren and Claes (2000) with permission from the publisher) © 2016 British Small Animal Veterinary Association

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5.2 Histological appearance of direct cortical bone healing. The areas of dead and damaged bone are replaced internally by Haversian remodelling. The fracture line has been graphically enhanced. (Reproduced from Perren and Claes (2000) with permission from the publisher)

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5.3

Diagrammatic representation of Figure 5.2 . The osteon carries at its tip a group of osteoclasts that drill a tunnel into the dead bone. Behind the tip, osteoblasts form new bone. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. © 2016 British Small Animal Veterinary Association

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5.3 Diagrammatic representation of Figure 5.2 . The osteon carries at its tip a group of osteoclasts that drill a tunnel into the dead bone. Behind the tip, osteoblasts form new bone. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.

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5.4

(a) Preoperative and (b) 6-week postoperative radiographs of a 6-month-old Boxer puppy. Despite the use of an intramedullary pin and cerclage wires, technical errors result in fracture instability. As the diameter of the bone increases due to callus production, so does the resistance to bending forces. © 2016 British Small Animal Veterinary Association

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5.4 (a) Preoperative and (b) 6-week postoperative radiographs of a 6-month-old Boxer puppy. Despite the use of an intramedullary pin and cerclage wires, technical errors result in fracture instability. As the diameter of the bone increases due to callus production, so does the resistance to bending forces.