Bone Fracture Healing

1.

About the patient:

• Age of patient

Fractures heal faster in young children than in any other age group. In general, the younger the child the faster a fracture may be expected to heal - up until the mid-late teenage years, after which bones reach their full size and the rate of healing of fractures is comparable to that of adults.

• General health of patient

People whose general health is good may expect fractures to heal faster than people who have on-going (long-term, or chronic) health issues.
The effect, if any, of other health problems e.g. difficulty in mobility, under-weight or over-weight, reduced immunity, etc. on the rate of healing of a fracture varies considerably. Medical staff may offer individual advice.

2.

About the bone:

• Type of bone

The rate of healing of fractures depends in part on the type of bone affected. It can also depend on which part of a particular type of bone (see the diagram on the right) has been fractured.

• Spongy bone
  (also called
  'cancellous bone')

  often heals faster than

• Compact bone
  (also called
  'cortical bone')

• Properties of specific bone

Apart from the type of bone and other general considerations some particular bones generally heal faster than others. For example, the clavicle bone (sometimes known colloquially as the "collar bone") generally heals well and in good time, despite being especially difficult to keep perfectly still during the fracture healing process.

• Pathology of bone

Some, but not all, of the common causes of pathological fracture may delay fracture healing (reducing the rate of healing = increasing healing time).

3.

About other aspects of the fracture:

• Mobility at the fracture site

Excess mobility of structures (e.g. the bones) and tissues may delay healing of fractures. Splints and plaster casts may be used to prevent excessive mobility at the site of the fracture until healing is sufficiently advanced.

• Separation of bone surfaces

Separation of the bone ends may delay or prevent healing on the bone such that broken parts are firmly and permanently reconnected.

4.

About other aspects of the injury:

• Joints at / near the fracture

If a fracture occurs at a joint the rate of healing of the fracture is sometimes reduced.

• Blood supply

If the supply of blood to the affected area has been disturbed e.g. restricted so reduced, the rate of healing of the fracture may be reduced and so the healing time increased. This is because the tissues of the body require sufficient blood supply to function correctly, especially when healing of disrupted tissues is taking place. Some important functions of blood include:

• Transport / supply of substances required by the tissues of the body,
  incl. dissolved gases (e.g. O₂ & CO₂), waste products of metabolism (e.g. water & urea), hormones, enzymes, nutrients, plasma proteins, and blood cells.
• Removing toxins from the tissues - toxins removed from the blood by the kidneys leave the body in the urine. Toxins also leave the body in the form of sweat.
  
• Regulation of body fluid electrolytes - e.g. excess salt

• Infection

Infection in the vicinity of fractures can delay healing (i.e. decreasing the rate of healing of the fracture = increasing the healing time).