Dr. Ketan Deshpande Registrar

1. BONE HEALING Ketan D Deshpande Dept. of Orthopedics ESIPGIMSR MGM Hospital

2. Bone Histology Cells in Bone

3. Bone Histology Periosteum & Endosteum

7. Irregular woven pattern of matrix collagen fibril

8. Four times the number of osteocyte per unit volume

9. Irregular pattern of matrix mineralization Less stiff & more easily deformed

11. Repair

13. Plasma exudat

14. inflammatory cells

15. PMN lecocytes

16. Macrophages

17. Lymphocytes

18. Haematoma

19. Inflammatory mediators Release by platelets inj.cells

21. Interleukin 1 & 6

22. Prostaglandin E2 (PGE2)Invitiation of the repair process

23. FRACTURE HEALING INFLAMMATION Inflammatory Necrosis Tissue and Exudate Resorbed Fibroplasty & Chondrocytes Appears Produce new matrix (The fracture callus)

25. Fibroblast Growth factor Angiogenesis

26. Osteoclast

27. Osteoblast Bone formation

28. Mesenchymal cells

29. Hard callus intramembranous bone

30. Soft callus endochondral ossification

31. Fracture callus matrix glycosaminoglycans, proteoglycans and collagen type I & III

32. BONE HEALING REPAIR

33. Bone Healing First phase of woven bone formation Later phase in woven bone formation

34. Bone Healing Chronology of mineralization in subchondral bone

37. BONE HEALING

39. Haversian remodelingOsteoclast resorb fracture line deposition osteoblast Blood vessels formation new bone matrix + osteocytes form new Haversian Systems or primary osteons

40. Bone Healing Direct bone formation in stabilized gap bone Courtesy AO Risert laboratory

42. Delaying formation repair tissue

44. Joint stiffness* Segmental fractures * Soft tissue interposition * Damage to the blood supply

48. T H A N K Y O U !