This week’s question was asked by an acquaintance.

QUESTION: How does a broken bone heal?

ANSWER: Bones can bend a bit, but if they bend too much, they break or fracture. Compare bones to a wooden pencil. A wooden pencil will bend, but if you try to bend it too much, it will snap in two. Bones behave the same way.

We might think of bones as solid, lifeless matter, sort of like a rock. But the skeleton is as much a living part of our body as our softer tissues and organs. The body stores minerals in the hard, compact bone. Bone stores fat in the yellow marrow and produces red blood cells in the inner red marrow. Bone is certainly alive.

There is good news about broken bones. Our bones are natural healers. At the site of the break, bones make a lot of new cells. New blood vessels develop that carry nutrients to help rebuild the bones. Those new cells cover both ends of the broken part of the bone and close up the break to make the bone as good as new. Sometimes broken bones can heal so thoroughly within a few months that even an X-ray can’t determine the original fracture line.

How long does it take for bones to heal? The amount of time depends on the type of fracture or break, the person’s age, overall health, nutrition, and blood flow to the bone. A young child may have a bone heal in three weeks, but it may take six weeks for a teenager with the same kind of break. What promotes fast healing? Good nutrition, which means a balanced diet with all the food groups. Healing bones need more nutrients than bones that are being maintained.

The worst thing for healing bones is smoking. Smokers have a much longer healing time and a higher risk of developing a non-union or non-healing of the bone. Smoking changes the blood flow to the bone, and it is that blood flow that delivers nutrients and cells to promote healing. Calcium supplements are sometimes recommended by the doctor. Taking a lot of calcium is fruitless. The body will reject an oversupply of calcium. Your doctor will recommend a treatment plan. That plan may include a cast, crutches, surgery, pins, rest, nutrition and time.

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There are different kinds of breaks, and X-rays are used to map the break. A hairline fracture is a thin break in a bone. A complete fracture means the bone is broken into two pieces. A greenstick fracture is a bone that cracks on one side. A comminuted fracture is when the bone is broken into more than two pieces or is crushed. An open fracture is when the bone sticks through the skin. Ouch!!

Various complications can occur with fractures depending on the bone − the severity of the break and the person’s age. Infection poses a threat to any compound fracture, as the break in the skin can allow germs to enter. Broken ribs can potentially pierce internal organs, and the healing process itself can inadvertently harm other organs or tissues. Pulmonary embolism occurs when a fracture’s blood clot breaks loose and blocks an artery. This condition is particularly common with hip and pelvis fractures, accounting for an estimated one-third of hip-fracture deaths.

With all of these possibilities in mind, a doctor approaches a suspected fracture by following several steps to ensure the bone heals properly. Diagnosis is the first step and involves the doctor determining whether a fracture occurred and, if so, the severity of the injury. The medical staff generally accomplishes this by examining the patient and inspecting the X-ray of the damaged area

The next step is immobilization to maintain proper alignment. This could mean a splint, cast, brace or sling. Sometimes traction is needed to ensure proper bone healing. In the case of more complex fractures, a system of weights, ropes and pulleys constantly pull on fractured limbs to maintain alignment.

Really bad cases may require surgery to remove foreign materials or bone fragments. The surgeon may employ metal rods, screws, and pins. Some fractures, such as those to the hip and joints, require artificial replacements.

Finally, there is rehabilitation: The same immobilization that keeps stress off the healing bone also leaves the surrounding muscles with little to do. This leads to the loss of muscle mass, strength and flexibility. Special exercise regimes allow individuals to gradually rehabilitate their newly healed limbs without risking re-injury. Sources: kidshealth.org and WebMD.

Send questions and comments to: lscheckel@charter.net.

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Larry Scheckel is a retired Tomah High School physics teacher.

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Tomah Journal editor

Steve Rundio is editor of the Tomah Journal. Contact him at 608-374-7785.

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