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Trauma/Fractures

How long does bone healing take?

Bone generally takes 6-12 weeks to heal. This does depend on the location and severity of the fracture however, with more complex fractures of bigger bones taking longer than 3 months.

Recovery from a fracture can also take longer than this, due to the impact on the surrounding structures. For example, if you fracture your tibia (bone in lower leg), you may be put into a cast and told not to weight bear until the fracture has healed. You will then develop stiff joints and weaker muscles.

Other factors can influence the healing times of bone.

What can hinder bone healing?

Many factors can influence how quickly bones takes to heal. These include:

  • Advancing age (we heal slower as we get older)
  • Medications (corticosteroids and immunosuppresants)
  • Medical conditions (diabetes, hormone=-related problems, vascular diseases)
  • Smoking (constricts blood vessels, reducing circulation of blood)
  • Poor nutrition or poor sleep
  • Low levels of calcium or vitamin D

Movement of bone fragments can also negatively affect healing, which is why fractures are sometimes put into a cast and weight-bearing is prevented.

However, weight-bearing/loading bones is also key to growth and production of new bone and therefore following a healthcare professionals advice is important to know when and how much to weight-bear.

How do bones heal?

Fractures/breaks to bones all undergo the same process of healing. This process has three overlapping stages:

  • Inflammation (several days)
  • Bone production (several weeks)
  • Bone remodelling (several months)

See below for these stages in more detail.

Inflammation (0-2 weeks):

Haematoma formation starts immediately after the bone is fractured and is closely followed by inflammation which lasts for several days. A haematoma is a collection of blood outside of the blood vessels (bruise).

The bleeding around the bone site leads to inflammation and clotting of blood at the fracture site. This provides the initial structural stability for producing new bone.

Bone production:

This can be broken down into 2 stages. Soft callus formation (2-3 weeks) and hard callus formation (3-6 weeks)

The clotted blood formed by inflammation is replaced with fibrous tissue and cartilage (soft callus). This is replaced with hard bone (hard callus) as the healing progresses.

Bone remodelling (8 weeks-2 years):

Bone remodelling is the final phase of bone healing, and can continue for many months. As the bone continues to form, it becomes compact and returns to its original shape. Blood circulation also improves to the area. In this phase, weight-bearing is more beneficial as there would have been adequate bone healing, and the weight on the bone helps to encourage bone remodelling.

During the process of bone healing, altered behaviours and movement patterns are likely to have occurred. Also, muscle wasting around the area is likely due to less impact/weight going through the body. This is where Physiotherapy plays a key role in rehabilitation.

Through strength and conditioning, an individualised exercise programme can be created, aimed at restoring the body to its previous level of function, and returning the individual to their normal activities.

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