The healing of a fracture is a complex and continuous process, which is artificially divided into four periods according to the characteristics of different stages of fracture healing:
Period of hematoma mechanization evolution: the hematoma at the fracture end gradually evolves into fibrous tissue, allowing the initial attachment of the fracture end. This process takes approximately 2 to 3 weeks. This period requires strict braking. The fracture end is fixed and stable to facilitate the initial connection of the fracture. Functional exercises are possible during this period, but should be light and based on muscle stretching activities.
Primitive bone demented formation period: the inner and outer periosteum proliferates to form bone-like tissue, and after calcification, the inner and outer bone demented are formed. The fracture reaches the initial osseous junction when the fibrous tissue in the medullary cavity is transformed into cartilage and the cartilage ossifies to form the annular and intraluminal bone idiocy. x-rays show the formation of the pike bone idiocy and the clinical healing phase, which spans a large period. The time required to heal varies by site and age. In children, the fracture heals quickly and takes less time; in the elderly, the time is relatively longer. Upper extremity fractures take less time than lower extremities. After the fracture is clinically healed, the external fixation can be removed and the joint can be gradually moved and weight-bearing can be done to promote the functional rehabilitation of the limb, which is also conducive to the further alteration and shaping of the primitive bone, making the bone stronger until it becomes normal bone tissue.
Mature bone plate stage: the primitive bone demented has irregular general morphology and disorganized tissue structure, which is immature bone structure and cannot fully meet the mechanical requirements yet. In the mature bone plate stage, the amount of bone in the primitive bone obsession further increases, the arrangement of bone trabeculae tends to be regular, and the primitive bone obsession is continuously cleared by osteoclasts, while the mature bone unit structure is formed. This process is repeated until the formation of mature, hard, plate-like bone.
Plastification period: during this period the newly formed bone tissue further matures, the deficient part of the bone tissue is further increased and the excess part is removed as required by the body mechanics. After shaping, the bone structure becomes regular, the medullary cavity is reopened, and the normal form before the fracture is restored. This stage is actually a revision process. During the plasticizing process, osteoclasts and osteoblasts work together. Osteoclasts dissolve the bone demented, forming a channel into which blood vessels then grow, and osteoblasts form bone, forming the structure of mature bone units.
