Healing of fractures is influenced by multiple factors. Same pattern of fracture would behave differently in different persons. Some of the factors are not modifiable but others are. A knowledge of these factors makes physician and patient both understand the outcome of injury and treatment better.
Age Of Patient: A fracture in children has higher rate of healing as compared to adults. Children have immense healing capacity. Time taken by a fracture to heal in a child is much shorter than adult. This rate of healing decreases as the child grows towards adulthood. A fracture of shaft of humerus that would unite in two weeks in a newborn child would take 6-8 weeks when he reaches puberty.
Severity of Injury: If injury is very severe, it affects soft tissues around the bone badly. As we know, [tag-tec]healing of a fracture[/tag-tec] is mainly contributed by tissues around the bone, therefore, the rate of union is slower when soft tissues are badly affected. This is especially true in case of bones which are subcutaneous. These bones have lesser tissue envelope already which is jeopardised easily.
Therefore rate of union is quite affected in [tag-tec]open fractures[/tag-tec] with soft tissue loss.
Type of Fracture: A [tag-tec]comminuted fracture[/tag-tec] would heal quicker than a [tag-tec]transverse fracture[/tag-tec] because former has larger surface area where cells can lay down new bone.
A fracture in [tag-tec]metaphysis[/tag-tec] heals quicker than [tag-tec]diaphyseal fracture[/tag-tec]. This again reflects higher [tag-tec]osteogenic[/tag-tec] power of cancellous bone than cortical bone.
A [tag-tec]displaced fracture[/tag-tec] would take more time to heal than [tag-tec]undisplaced fracture[/tag-tec] as anatomy has been disturbed in former and blood supply is more affected.
Pathological Fractures: Fractures that occur a result of any preexisting pathology such as infection or malignancy in the bone are called pathological fractures. These fractures are slow to heal.
Bone Quality: Osteoporotic fractures are frequently affected by healing problems because the bone stock is not good. This is related to problems in carrying out a treatment rather than healing capacity.
Infection: Open fractures are more liable to get infected. Infection severely compromises the rate of fracture healing and frequently results in [tag-tec]non union[/tag-tec] of fracture.
Personal Habits: Smoking and other drugs cause [tag-tec]vasoconstriction[/tag-tec] and are thought to adverse to fracture healing.
Treatment: An early and adequate treatment always has better results than delaying and inadequate treatment.
Systemic Disease: There are many systemic diseases that may affect the mileu that results in fracture healing. This could be due to disease per se or due to treatment. For example radiotherapy or chemotherapy being received for a malignancy other than fracture site may hamper with fracture healing.
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