basic science
Fracture Healing Biology
intermediate
6 min
28 marks
6 questions
Clinical Scenario
A 35-year-old male presents 4 months after closed treatment of a midshaft tibial fracture. Radiographs show persistent fracture lines with minimal callus formation. He has pain with weight-bearing and tenderness at the fracture site. He has been non-weight-bearing and is a smoker (20 pack-years).
Radiographs at 4 months are provided.
Radiographs at 4 months are provided.
Clinical image for Fracture Healing Biology
Image source: Open Access medical literature (NIH/PubMed Central) • CC-BY License
Questions
Question 1 (4 marks)
Describe the stages of fracture healing. What is the difference between primary and secondary bone healing?
Question 2 (5 marks)
What factors influence fracture healing? Classify them into local and systemic factors.
Question 3 (6 marks)
Define delayed union and nonunion. What are the types of nonunion and their radiographic characteristics?
Question 4 (5 marks)
Describe the biological and mechanical factors that determine the type of healing. What is the role of strain in fracture healing?
Question 5 (4 marks)
What interventions can enhance fracture healing? Describe the evidence for each.
Question 6 (4 marks)
How would you manage this patient's delayed union?