Bone Fracture Repair and Healing All You Need to Know

01 Jul 2019

Bone Fracture Repair and Healing: All You Need to Know

If you’ve ever had a broken bone, you probably didn’t enjoy the bone healing process very much! In addition to the pain, you had to wear a cast or brace, that almost certainly slowed you down for several weeks.

Bones break or fracture as a result of stress or sudden impact. We care for simple fractures that remain under the skin in our urgent care clinic  and Telemedicine for urgent care. A compound fracture, which is when the bone breaks through the skin, needs to be treated in an emergency room. We can assess a break for whether hospital treatment is required. 

Understanding bone fracture healing might make the whole process seem more logical and bearable for people stuck at home with a cast.

People Experience Fracture Healing in Different Ways

People heal differently depending on factors like age, general health, and where the fracture occurred. In general, the bone healing process usually takes six to eight weeks.

Older people take longer to heal and are less likely than younger people to resume normal activities after a bone break. That’s because the quantity and quality of cells that rebuild fractured bones decreases with age. And unfortunately, seniors have more complications and even death rates from broken bones, something that really needs further study as this report urges.

The good news is that pain associated with fractures goes away pretty quickly, thanks to painkillers and the natural healing process! Most people are reasonably comfortable while their bones are healing.

Three Stages of Bone Healing 

The fracture healing process begins with soft tissue that is gradually replaced with firmer, more defined materials and finally, new bone.

Bones heal in three distinct stages:

1. The inflammatory stage

The first stage starts right after the fracture and begins with pain — a sign that something is wrong. Blood vessels torn by the fractured bone release blood that clots and forms a fracture hematoma (bruise) around the bone. It kills off some of the blood cells around the bone for about a week.

2. The repair stage

The second one overlaps with the inflammatory stage and begins in earnest a few days after the fracture. This is when the body starts to heal the bone by developing new cartilage and tissue called calluses that form at both ends of the break to stabilize it. 

They will gradually be replaced by bonier but porous calluses called a trabecular bone. It contains lots of veins with red bone marrow and blood cells that produce the bone cells needed to rebuild the bone: osteoblasts, osteoclasts, osteocyte, and osteoprogenitor. 

3. Bone remodeling stage

The last one is the bone remodeling stage where the spongy, porous bone is replaced by actual solid bone. The solid bone may have some swelling on its outer surface, but this will go away as it matures.

Ensuring Proper Bone Fracture Healing

If you’re wondering, “well why do I need a doctor if my bones are regenerating?” it’s because the actual breaks do need to be reset so that bones don’t heal unevenly or in an unnatural position. Physicians are trained to manipulate breaks so that they are anatomically set in the right position for healing.

A broken bone that isn’t properly reset can lead to a lot of problems in muscles, tissues, and joints near the break, including a blood clot or infection, damage, and swelling directly into joints. 

Breaks to long bones, like femurs (thigh bones) can result in a fat embolism, in which fat globules enter the bloodstream and might reach the capillaries (blood vessels) to the lungs. This can cause respiratory distress — interference with breathing — that can lead to a whole new set of serious issues including pneumonia, brain injury, and even death.

The normal practice is to numb the area first, before resetting the bone underneath. However, former NBA star Steve Nash reset his own broken nose during the 2010 playoffs, much to the horror of his teammate Grant Hill and countless fans. 

Physicians Reset Broken Bones to Ensure Proper Bone Fracture Healing

Open Reduction Procedure

In some cases, open reduction surgery is needed to properly reset a severe break or a bone with multiple fractures.

  • Open reduction with internal fixation is when the surgeon attaches metal plates or screws to the bone, or put metal rods in the center of the bone to hold the shattered pieces together.
  • Open reduction with external fixation is when the surgeon attaches a rod-like device to the limb following surgery. Metal pins and screws above and below the fracture site hold the rod in place. 

What Are the Signs that a Broken Bone is Healing?

This is an understandable question given some of the extreme measures that may be needed in fracture healing.

Generally speaking, pain lessens with time and this is due to the healing process. However, it’s difficult to tell if your broken bone is healing when the affected body art — usually the leg, arm, wrist, or foot — is encased in a cast. 

Your doctor will be in the best position to check on the healing process. He or she will gently remove the cast — the amount or lack of pain or discomfort when this occurs is a sign of healing right there. Then, the area will be x-rayed and compared to the initial, post-break x-ray. The callus development plus gaps left by the break should be filling in — a very positive sign of healing.

At some point, your doctor will replace a hard cast with a functional cast or healing brace that allows a little bit of mobility. Many patients find this stage to be a huge relief, as they finally can clean the area, and get some relief from itching!

Ways to Support the Bone Fracture Healing

There are several steps you can take to help your body heal that fracture, starting with taking supplements:

  • Protein supplements help provide this key building block for bones. Lack of protein can result in a rubbery callus, rather than a spongy one.
  • Antioxidants remove free radicals that arise from damaged tissue and go on to damage protein, cells, and even DNA.
  • Mineral supplements, especially calcium, magnesium, phosphorus, silicon, and zinc that speed up callus growth and protein production in the bone.
  • Vitamins, particularly C, D, and K, which help with healing, and B, which can boost energy. Healing from an injury can be exhausting.

Be sure you discuss these supplements with your doctor to make sure you take the right amounts, and that they don’t interfere with medications you take.

If you smoke, this is a good time to stop. Smoking makes your body work harder to heal. Ask your doctor about nicotine patches or other smoking cessation tools.

Follow your doctor’s instructions about exercise in general and the affected area in particular. Light exercise stimulates blood flow to the injury, which helps rebuild muscle around it. For example, brisk walks can be great to heal an arm or wrist injury.

If you’re healing from a bone fracture and want fast access to follow-up care, you should know our urgent care clinic and Telehealth solution for urgent care is open seven days a week. Contact us for an appointment now!

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