Last time we were discussing the three phases of bone healing and how your foot bone fracture heals up. When one first fractures their bone there is a rupture of small blood vessels and there is bleeding at the site, thus the swelling to the area next the blood vessels constrict and the bleeding stops. The blood in the area forms something called a hematoma- sometimes they become a source for infection. The rest of the blood cells there die but a cell called fibroblasts survive and form granulation tissue.  That process happens over the first few days.

Phase two called the reparative phase then begins. the new beginnings of bone begin to form. The cells don’t start off as bone cells they actually start off as chondroblasts which form hyaline cartilage. Then the osteoblasts will start to form bone callus. then the cartilage and woven bone is replaced with lamellar bone. the lamellar bone starts to mineralize and is soon replaced by trabecular bone. Trabecular bone is a softer version of bone that is not quite as strong as natural bone.

Phase three is the remodeling stage. This is the process where trabecular bone is replaced with compact bone, and over time the bone regains its original strength . Remodeling can take three to five years.

Just to review it is important to realize that there are many things that can slow down fracture healing. When i talk about fracture healing I am also referring to

healing of osteotomies (which is when your surgeon cuts your bone to put it in a different position) and joint fusions which is when your surgeon takes two bones and fuses them together by removing the cartilage and locking the bones together such as an ankle fusion or a first metatarsophalangeal joint fusion)

Things that can slow down bone healing are number one being a smoker. Your age can affect your healing rate. Diabtetes and anemia and osteoperosis can slow healing. And taking NSAIDS such as Motrin Advil , Aleve, Ibuprofen and Naprosen. In a future post we will discuss how to speed up bone healing in bone fractures.  As always email me with any questions.