GRANULATION TISSUE

AND
FRACTURE HEALING

ROLL NO-171 TO 180

 GRANULATION
TISSUE
PATHOLOGY

It is a specialised type of tissue unique and hallmark of

repair after wound healing.

Migration and proliferation of fibroblasts and deposition

of loose connective tissue, together with the vessels and
interspersed leukocytes, form granulation tissue.
The term granulation tissue derives from its pink, soft,
granular gross appearance, such as that seen beneath the
scab of a skin wound

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HISTOLOGIC
APPEARANCE
1.Proliferation of fibroblasts and new
thin-walled

2. Delicate capillaries (angiogenesis),

in a loose extracellular matrix, often
with admixed inflammatory cells,
mainly macrophages (hallmark of
granulation tissue).

3.scattered chronic inflammatory cells.

GRANULATION TISSU
E GROSS APPEARANCE

Pink ,soft, granular appearance of tissue on surface of

granulation tissue on surface of healing wounds.

During the migratory phase of wound healing,granulation tissue is:

• Light red or dark pink,being perfused with new capillary loops or

buds

• soft to the touch

• moist

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• bumpy (granular) in appearance ,due to punctate hemorrhages

• pulsatile on palpation.
 KJ
GRANULATION TISSU
E

,,,,,,,,,,,,,,
Functions:-
Granulation tissue is a type of new connective tissue, and microscopic blood vessels have
three main functions.
Immune: Protects the wound surface from microbial invasion and further injury.
Proliferative: Fills the wound from its base with new tissue and vasculature.
Temporary plug: Replaces necrotic tissue until replacement by scar tissue.
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 CLINICAL
GRANULATION TISSUE

SIGNIFICANCE
Granulation tissue may persist under several circumstances resulting from
underlying conditions and/or errors in the stages of wound healing (errors
in the proliferative phase and remodeling phase)

1.Possible causes of prolonged wound healing include:

•Diabetes mellitus,Rheumatoid arthritis,Vascular or arterial insufficiency

And Alcoholis

2.Possible causes of Hypergranulation (excess granulation tissue)

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•Wound infection,Excess inflammation And Foreign body/material
FRACTURE HEALING

FRACTURE
HEALING
A fracture is a broken bone.It can range
from a think crack to a cocomplete
break in the bone.

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FRACTURE HEALING
STAGES OF FRACTURE
HEALING
The stages are:
1.Inflamatory phase
2.Reparative phase
3.Remodling phase

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 INFLAMMATORY PHASE
FRACTURE HEALING

● Soon after fracture blood vessels rupture which

leads to hemorrhage.
● Fibrin meshwork in the clotted blood helps to
seal the fracture
● The inflammatory cells and Platlets release
cytokines ;activate the osteoprogenitor cells in
periosteum,medullary cavity and surrounding soft
tissues.
● Formation of granulation tissue
●Soft tissue Callus or procallus Formation

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FRACTURE HEALING
REPARATIVE PHASE
●As the healing advances,callus are replaced
by lamellar bone.
●This is stronger and consists of parallel
collagen fibres.
●This replacement process is known as
endochondral ossification w.r.t the hyaline
cartilage and bony substituion w.r.t. woven
bone.
● As the mineralization proceeds, the
stiffness and strength of the callus.

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 REMODELING PHASE
FRACTURE HEALING

●Several weeks after a callus has sealed the bone

ends the remodeling phase begins.
●Resorption of excess portions of bony callus
around the fracture site which are slowly resorbed
by osteoclasts and decrease the size of callus.
●This phase continues till the original bone shape,
outline and strength of the fractured bone is re-
established.

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 CAUSES AND COMPLICATIONS
FRACTURE HEALING

Complications
● Delayed union and non
union of fracture.
● Pseudoarthrosis
● Large callus with deformity

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THANK YOU