Conditions that compromise fracture healing include diabetes, hypothyroidism, excessive chronic alcohol use, and smoking. An adequate balanced diet and sufficient amounts of vitamin D and vitamin C are essential for normal fracture healing. Nutritional factors are also important in the healing process. 2 Fractures in patients with a hormonal imbalance generally heal, although union may be delayed. Growth hormone, thyroid hormone, insulin, calcitonin, cortisol, anabolic steroids, and gonadal steroids all play roles. Whereas children's fractures heal rapidly, fractures heal much more slowly in older persons. Because of this, intraarticular fractures must be in excellent alignment and sufficiently stabilized to reduce the possibility of poor healing.Īge is one of the most important factors that influence bone healing.
Intraarticular fracture healing may be delayed because of excessive motion of fracture fragments or synovial fluid collagenases that weaken the fracture callus.
When the healing process is arrested, a nonunion occurs, and a pseudarthrosis or fibrous tissue that does not progress to complete healing forms at the fracture site. When fracture healing progresses more slowly than usual, it is referred to as delayed union.
Fracture healing ranges from rapid and complete to delayed or incomplete. Severe injuries with significant soft tissue and bone damage, open fractures, segmental fractures, inadequate blood supply, and soft tissue interposition adversely affect healing. In Fracture Management for Primary Care Updated Edition (Third Edition), 2018 Factors That Influence Fracture Healingįracture healing is a complex process and can be influenced by a number of injury, patient, and treatment factors.
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