Biology of fracture healing
A recent study published in the Journal of Orthopaedic Surgery mention that 41% of patients with non-union are unable to return to work 12 months post injury. This high number drives the research to better investigate the question of pathophysiology during non-union, as well as biological pattern of normal fracture healing. Physiological bone healing starts with bleeding and haematoma formation after the fracture. Local stem, inflammatory and procoagulant cells cause inflammation and stabilisation of the haematoma. After that mesenchymal, progenitor cells and fibroblasts participate in soft callus formation. It takes few weeks to form fibrocartilaginous fibrous tissue. At this stage there is a gradual resolution of pain from the fracture. During the phase of healing fibrocartilage is converted to lamellar bone that finally goes through remodelling.