What Is The First Step In Bone Repair Following A Break?

38.2E: Os Remodeling and Repair

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Bone is remodeled through the continual replacement of old bone tissue, also as repaired when fractured.

Learning Objectives

• Outline the process of bone remodeling and repair

Central Points

• Os replacement involves the osteoclasts which break down os and the osteoblasts which make new bone.
• Os turnover rates differ depending on the bone and the area inside the os.
• There are four stages in the repair of a broken os: 1) the formation of hematoma at the break, two) the formation of a fibrocartilaginous callus, 3) the formation of a bony callus, and 4) remodeling and add-on of compact os.
• Proper bone growth and maintenance requires many vitamins (D, C, and A), minerals (calcium, phosphorous, and magnesium), and hormones ( parathyroid hormone, growth hormone, and calcitonin ).

Primal Terms

• callus: the material of repair in fractures of bone which is at get-go soft or cartilaginous in consistency, but is ultimately converted into true bone and unites the fragments into a single piece
• spicule: a sharp, needle-like piece
• fibroblast: a cell constitute in connective tissue that produces fibers, such every bit collagen

Os Remodeling and Repair

Bone renewal continues after birth into machismo. Bone remodeling is the replacement of old bone tissue by new bone tissue. Information technology involves the processes of bone deposition or bone product done past osteoblasts and bone resorption done by osteoclasts, which break down old os. Normal bone growth requires vitamins D, C, and A, plus minerals such as calcium, phosphorous, and magnesium. Hormones such as parathyroid hormone, growth hormone, and calcitonin are also required for proper bone growth and maintenance.

Bone turnover rates, the rates at which sometime bone is replaced by new bone, are quite high, with five to seven per centum of bone mass beingness recycled every week. Differences in turnover rates exist in different areas of the skeleton and in different areas of a bone. For instance, the bone in the head of the femur may exist fully replaced every half-dozen months, whereas the bone along the shaft is altered much more slowly.

Bone remodeling allows basic to adapt to stresses by becoming thicker and stronger when subjected to stress. Bones that are not discipline to normal everyday stress (for example, when a limb is in a bandage) will begin to lose mass.

Effigy \(\PageIndex{ane}\): Stages of fracture repair: The healing of a bone fracture follows a series of progressive steps: (a) A fracture hematoma forms. (b) Internal and external calli form. (c) Cartilage of the calli is replaced by trabecular os. (d) Remodeling occurs.

A fractured or broken bone undergoes repair through iv stages:

1. Hematoma formation: Blood vessels in the broken bone tear and hemorrhage, resulting in the germination of clotted blood, or a hematoma, at the site of the break. The severed blood vessels at the broken ends of the bone are sealed past the clotting process. Os cells deprived of nutrients begin to die.
2. Bone generation: Within days of the fracture, capillaries grow into the hematoma, while phagocytic cells begin to clear away the expressionless cells. Though fragments of the blood clot may remain, fibroblasts and osteoblasts enter the surface area and brainstorm to reform bone. Fibroblasts produce collagen fibers that connect the broken bone ends, while osteoblasts start to form spongy os. The repair tissue between the broken bone ends, the fibrocartilaginous callus, is composed of both hyaline and fibrocartilage. Some bone spicules may likewise appear at this signal.
3. Bony callous formation: The fibrocartilaginous callus is converted into a bony callus of spongy bone. It takes about 2 months for the cleaved bone ends to exist firmly joined together after the fracture. This is like to the endochondral formation of os when cartilage becomes ossified; osteoblasts, osteoclasts, and os matrix are nowadays.
4. Bone remodeling: The bony callus is then remodelled past osteoclasts and osteoblasts, with excess material on the exterior of the bone and within the medullary crenel being removed. Compact bone is added to create bone tissue that is similar to the original, unbroken bone. This remodeling can take many months; the bone may remain uneven for years.

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