Hematoma is formed. Blood vessels are ruptured when the bone breaks. As a result, a blood-filled swelling called a hematoma (hemah-
to’mah) forms. Bone cells deprived of nutrition die.
The break is splinted by a fibrocartilage callus. As described in chapter 3, an early event tissuerepair (and bone is no exception) is the growth of new capillaries (granulation tissue) into theclotted blood at the site of the damage, and the disposal of that tissue by phagocytes. As this on,connective tissue cells
of various types form a mass of repair tissue. Fibrocartilage callus (kal’us),
that contain several elements some cartilage matrix, some bony matrix, and collagen fibers and
acts to “splint” t
he broken bone, closing the gap.3.
The bony callus is formed. As more osteoblasts and osteoclasts migrate into the area andmultiply, fibrocartilage is gradually replaced by a callus made of spongy bone, the bony callus.4.
Over the next few months, the bony callus is remodeled in response to the mechanical stressedplaced
on it, so that is form a strong permanent “patch” at the fracture site.
SimpleBone breaks cleanly, but does not penetrate the skin.
Sometimes called a “closed fracture”.
CompoundBroken ends of the bone protrude through soft tissues and the skin.An open fracture. More serious than a simple fracture. May result in severe bone infection(osteomyelitis) requiring massive doses of antibiotics.c.
ComminutedBone breaks into many fragments.Particularly common in the aged, whose bones are more brittled.
CompressionBone is crushed.Common is porous bones (i.e. osteoporotic bones)e.
DepressedBroken bone portion is pressed inward.Typical of skull fracture.f.
ImpactedBroken bone ends are forced into each other.Commonly occurs when one falls and attempts to break the fall without stretched arms, alsocommon in hip fracture.g.
SpiralRagged break occurs when excessive twisting forces are applied to a bone.Common sports fracture.h.
GreenstickBone breaks incompletely, much in the way a green twig breaks.Common in children whose bone have relatively more collagen in their matrix and are moreflexible than those of adults.