Our bones are pretty strong, but no matter how strong they are, they can break when faced with strong forces, high impacts or stresses from unusual angles. When a bone breaks, it’s medically called a bone fracture.

Different levels and types of fractures

There are different types and grades of bone fractures too, from

• the simple hairline “cracks”
• to full fracture but still in place (medically termed as “stable and undisplaced”)
• to the much more serious fractures which may include two or more bone pieces (this is called “comminuted fracture”); fracture pieces that may have moved (called displaced fractures) as well as those that pierce through skin or compacted

Bone Fracture Healing

There are four stages of bone fracture healing:

• Stage 1: Immediately after a fracture (simple to complex), there will be a lot of bleeding within the bone because there will be many internal blood vessels that are torn. Within a few hours, there will be a large fracture blood clot (called hematoma) at the bone fracture site
• Stage 2: In normal healing individuals, the bone will start to form and heal within 4 weeks. Xray will show formation of bone and cartilage around the fracture site to stabilize the fracture (this is the external callus). Soon after, these external callus cells will start to specialize and become osteoblasts that will lay on new bone cells which will slowly fill the bony gaps between the fracture fragments (this phase is known as temporary fracture stabilization). Patients may be placed early into a customized splint to protect the fracture.
• Stage 3: as the fracture continue to heal and repair, the osteoblasts will replace the cartilage of the external callus with spongy bone and once it’s been fully replaced, the internal and external callus will then merge and solidify to become a solid brace-like support. The spongy parts will connect and gel the broken pieces together whereas the dead bones and areas of bones closest to fracture site will be removed (by absorption) and replaced. At this point, the broken ends of the bony fragments are now connected fairly securely and can stand normal loads and muscle contractions.
• Stage 4: There on from months 4 to months 12 (one year), the osteoblasts will continue to absorb callus and keep forming new bone and refine the fracture injury area. This is known as bone fracture remodelling. Once the bone remodelling is 100% complete, calluses will disappear and only strong living bones remain. Even the bulges at the bone fracture site will be removed, and the bone will have returned to its original size and shape.

Physiotherapy Post Fractures

During this time of fracture and fracture healing and after the fracture has healed, you may be referred to be treated by physiotherapists and hand therapists to work on your

• pain
• stiffness
• movement
• function

 

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