Re: [HS] Expert advice required

On Sat, 17 Nov 2007 03:30:59 +0100, steve common
<steven.common@xxxxxxxxxx> wrote:

. . .
g) Do any of you have experience of a broken toe which still hurts into
the 4th month after the injury?
. . .

Quotes below are from this site:
http://www.engin.umich.edu/class/bme456/bonefracture/bonefracture.htm

:: ...there are three distinct phases of fracture healing: 1) inflammation,
:: 2) reparation, and 3) remodeling. The first phase, inflammation,
:: occurs immediately following the bone fracture. At that time, a
:: hematoma or blood clot occurs at the fracture site. This hematoma
:: provides two important factors important for fracture healing. First,
:: the hematoma provides a small amount of mechanical stability to the
:: fracture site. Second, and perhaps more importantly, the hematoma
:: brings osteoblast, and chondrocyte precursors to the fracture site in
:: large numbers that can begin to differentiate into osteoblasts and
:: chondrocytes to begin producing matrix. In addition, macrophages and
:: osteoclasts come into the site to remove damaged and necrotic tissue.
:: Also, since bone fracture usually involves disruption of the
:: periosteum surrounding the bone, more precursor cells from the
:: periosteum will be introduced into the fracture site. The will begin
:: the process of making a fracture callus through the general process of
:: osteogenesis, laying down bone on soft tissue. Both types of
:: osteogenesis, intramembranous and endochondral ossification may be
:: occuring at the fracture site. The resulting proliferation of woven ::
:: bone tissue will produce a fracture callus, bridging the fracture gap.
::
:: The second step in the biology of fracture healing is the
:: reparation phase. In this phase, the processes of osteogenesis
:: continue and a fracture callus bridges the fracture site.
:: . . . The healed bony callus is formed of woven bone
:: and primary bone. At
:: this point, it consists of a large bony bridge connecting the two
:: bones. The base material of the callus typically will have lower
:: strength and stiffness than mature lamellar bone. It is the large mass
:: of bone in the callus that gives the construct its strength. To reduce
:: the callus mass while maintaining mechanical integrity the callus must
:: be remodeled to produce the lamellar bone. During the remodeling
:: period, the large fracture callus is reduced to become the size of the
:: bone at the fracture site. The woven/primary bone is replaced with
:: secondary lamellar bone. This process may take months or even up to a
:: year or more in adults.

A year or more in adults. Oh, and while it happens, there will be
discomfort: the periosteum, the interosseous membranes, the places
where tendons adhere, are all growing / re-growing. For a long time.

Good luck!
--
Daniel ( deltaechomike@xxxxxxx )
.

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