BROKEN BONES!

Our bones are the strongest part of our bodies. Without bones, we'd all be moving around like "The Blob"! But even though bones are so strong, they can break. Any type of break in any bone is called a FRACTURE. Children are most susceptible to fractures because their bones are still growing, and are relatively soft. Bones don't stop growing and hardening until late adolescence. However, anybody of any age can suffer a fracture.

TYPES OF BONE FRACTURES

COMPLETE: A complete break across the bone, resulting in a bone that's in two or more pieces.

PARTIAL: The break doesn't go all the way through the bone.

SIMPLE (OR CLOSED): The broken bone does not break through the skin.

COMPOUND (OR OPEN): One or both broken ends of the bone break through the skin.

STRESS: Very small cracks in a bone that can happen after repetitive activities that put stress on bones, like running or basketball. About 25% of all stress fractures occur to the tibia (shinbone).

IMPACTED: The two broken ends of the bone are driven together.

SPIRAL: The bone is twisted apart (think of wringing out a wet rag until it rips in two).

GREENSTICK: A partial break where one side of the bone breaks and the other side only bends. Greenstick fractures happen only in children, whose bones are more flexible than adult bones.

PATHOLOGIC: Sometimes fractures can occur in bones weakened by a disease process such as osteoporosis or bone cancer. In people with very weak or brittle bones, a minor fall, or something as relatively harmless as peeling potatoes can result in a fracture.

THE FOUR STAGES OF BONE HEALING

1. The blood vessels damaged during the break form a clot around the site of the fracture. This is called a FRACTURE HEMATOMA.

2. Capillaries (tiny blood vessels) infiltrate the fracture hematoma, and form GRANULATION TISSUE, which is like scar tissue. Cells invade the tissue and produce COLLAGEN, a fibrous substance that helps connect the broken ends of the bone. Other cells produce FIBROCARTILAGE, which forms a callus around the fracture. This FIBROCARTILAGINOUS CALLUS lasts about three weeks.

3. Other cells develop into OSTEOBLASTS (bone cells), and begin forming a substance that will join with bone fragments at the site of the fracture. Eventually, the fibrocartilage will be transformed into a BONY CALLUS composed of spongy bone. This stage lasts 3-4 months.

4. The last stage of bone repair is REMODELING. The cells absorb any dead portions of bone remaining, and the spongy bone found in the bony callus is replaced by dense bone tissue. Often, the only evidence of a healed fracture is a thickened area on the bone's surface, indicating the area of the fracture.

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