Bones Repair After Fracture
by a Four-stage Process
Bones can reform after being fractured (broken). The
classification of fractures depends on whether the bone is
splintered (partial), entirely broken (complete), or shat-
tered (
comminuted,
KOM-i-noo-ted
). If the broken bone pro-
trudes through the skin, it is an
open fracture.
If it remains
within the skin, it is a
closed fracture
(Figure 5.5).
Broken bones are repaired through the four-stage pro-
cess outlined in Figure 5.6.
To treat fractures, the broken ends of the bones must
be brought together and aligned in a process called reduc-
tion. The ends must then be immobilized for healing. Re-
duction can be accomplished by manipulating the broken
ends of the bone without rupturing the skin
(closed reduc-
tion)
or by surgical insertion of screws, pins, and/or plates
(open reduction).
Bones take many months to heal complete-
ly because the fracture interferes with the blood supply to
the bone, and the bone’s strength comes from its extracel-
lular matrix that has also been disrupted by the fracture.
B one fractu res • Figure 5.5
Bone fractures come in many forms, including open fracture; greenstick fracture;
comminuted fracture; and impacted fracture.
Humerus
Radius
Ulna
Open
fracture
(also complete) The bone is broken into two or
Greenstick
fracture
The bone is partially broken and one piece bends;
more pieces (complete) and protrudes through the skin (open)
only occurs in children
Humerus
Comminuted
fracture
(KOM-i-noo-ted) The bone is crushed
into small pieces, which lie between the ends of the main
broken bone fragments
Humerus
Impacted
fracture
One broken end is forced into the
interior of the other
120
CHAPTER 5
The Skeletal System
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