Getting a bone fracture is a common injury for most of us, especially for people into sports or a job that takes a lot of physical movement. However, bone healing is a complex process that you need to understand to know where you are in the healing phase.
There are two types of bone fracture healing – direct healing and indirect healing. Direct healing is a condition that surfaces when your bony fragments are fixed well with compression. In this case, the bony ends are healed and joined by osteoblast and osteoclast activity, without callus formation.
Indirect healing involves intramembranous and endochondral bone healing. It is a more common healing type that doesn’t require stable conditions and anatomical reduction. There is callus formation during indirect healing that results in secondary bone formation.
Bone Healing Process
Most types of bone fractures heal in the same process – be it a fracture caused during a surgical procedure or one that is a result of an injury. There are three stages of bone healing, such as:
Inflammation: Right after the fracture, there’s inflammation that lasts for days or weeks. Due to the fracture, internal bleeding in the injured area leads to inflammation and blood clotting. It may look like a bad situation to be in but provides the basic structural stability and foundation for the formation of new bone.
Bone formation: The next stage of the healing process is the formation of a new bone that begins with the removal of the blood clot with cartilage (soft callus) and fibrous tissue. As time goes by, the hard callus or hard bone replaces the soft callus or cartilage. Your orthopedist tracks this development on X-rays after a few weeks of the fracture.
Bone remodeling: The third or last stage of bone healing is the remodeling of the newly formed bone. Sometimes, it takes months for the bone to turn compact and get into the original shape. The blood circulation in the fractured area also improves. Soon after proper bone healing is in progress, weight-bearing promotes efficient bone remodeling.
Time required for bone healing
Being a complex process, bone healing doesn’t provide a definite period and differs from person to person. The healing time depends on multiple parameters, such as the age of the patient, fracture type, nutritional status, and hidden medical conditions.
The suggested bone healing by most orthopedists is 6-8 weeks. If your child has got a bone fracture, it may heal faster than the fracture you had a few months back. You need to follow your doctors advise on when to start walking or standing (leg fracture) or lifting weights or exercising (hand fracture) to ensure complete bone healing.
Complications in bone healing
Some factors may disrupt the flow of your bone healing process, like:
- Movement of the bone fragments
- Older age
- Impaired metabolism or poor nutrition
- Bearing weight too soon
- Underlying medical conditions, such as hormone-related issues, diabetes, or vascular disease
- Certain medications like most immunosuppressant and corticosteroids.
- Continuous smoking (decreases blood circulation by constricting blood vessels)
- Severe and complicated fracture, or the cases of an infected fracture