Wound healing from a bone fracture | Physiotherapy after a bone fracture

Wound healing from a bone fracture

If there are only two parts of the fracture which are still very close together, it is possible that these parts can grow together again without surgery by immobilising them in a plaster cast and then applying appropriate stress stimuli. In all other cases, the fracture parts are reconnected by various surgical methods (nail, screws, plate, external fixator, …) and brought into their physiological position so that the bone has a chance to grow together again.Wound healing in the body can be divided into different stages for all wounds and injuries, and therapy/physiotherapy is also based on these stages. Depending on the injured structure, the duration of the individual phases varies.

For example, well perfused body tissue heals much faster than tissue with little blood supply. General wound healing phases are first the inflammation phase, then the proliferation phase, in which new tissue is formed, and finally the remodelling phase, in which the tissue becomes firmer and gradually returns to its original function. It is not possible to make a general prognosis because there are too many fracture sites and types.

However, today there are so many different and good treatment options and therapeutic post-treatment concepts (including physiotherapy) that in most cases unrestricted function can be restored. More problematic are bone fractures with joint involvement, but even these can be operated, treated and their function restored.

• In the case of bone, it takes about six weeks for a temporary bone substance to form and solidify. From this point on, the bone can usually be fully loaded again.
• After about three months, the substance has further strengthened, but it can take up to a year before the full original load-bearing capacity is restored and the temporary bone substance is transformed back into stable solid bone.

Building a bone

Bone is a very firm, hard and stable form of connective tissue. There are about 200 bones in the body, which together form the human skeleton. They differ in their structure, appearance and function.

On the one hand, there are the long tubular bones on arms and legs, flat bones such as the shoulder blade, the small foot and hand bones, sesamoid bones such as the kneecap, which have a leverage effect in the distribution of force, and special bones such as the vertebrae, which form the spine or the skull bones. The individual bones are structured from the outside to the inside as follows: the outermost layer is the periosteum, the so-called periosteum, underneath which there is a hard compact cortical layer (Kompakta), which is followed by the spongy bone tissue (spongiosa). In the middle there is the bone marrow cavity and the bone marrow. The individual bones are connected by joints – real or fake. This structure enables the stable skeleton and thus the body to move.