Chapter 2 Fracture Repair and Bone Grafting
نویسنده
چکیده
Fracture healing involves a highly integrated sequence of events through which bone is restored to its preinjured condition. The events that occur during healing have been classically divided into four phases: inflammation, soft callus, hard callus, and remodeling (Figure 1). Initially, during the inflammatory stage, a hematoma forms in response to the trauma, and the inflammatory cells in the hematoma débride the wound and may help recruit cells that facilitate repair. As skeletal progenitor cells are recruited and begin to differentiate into osteoblasts and chondrocytes, the hematoma is slowly transformed into a soft callus composed primarily of cartilage. At this time, osteoblasts form a collar of bone adjacent to the fracture gap. After this initial period of stabilization, chondrocytes undergo a maturation process, the matrix becomes calcified, osteoclasts remove the calcified cartilage, and endothelial cells invade the cartilage. The soft callus becomes a hard callus as bone forms behind the invading vasculature. Once formed, the bone is remodeled until the skeletal injury has been completely repaired and the bone marrow cavity has been restored.
منابع مشابه
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تاریخ انتشار 2011