Abstract
Bone healing is a complex biological process involving various anatomical and mechanical events along with expression of various genes, allowing changes in cells and leading to fracture union. There are primarily two ways the bone heals; primary bone healing and secondary bone healing. Primary bone healing in other words is direct intramembranous healing whereas the indirect bone healing involves both intramembranous and enchondral bone formation. In a well-fixed fracture, the bone is expected to heal with direct bone healing as the bone is anatomically reduced and fixation provides stable environment. We discuss the endpoint for a successful fixation based on clinical examination and radiological support.
Fracture union remains largely a clinical diagnosis. The triad of displacement, stability, and biology dictates fracture union. In a well-fixed fracture, radiological tests provide little evidence on healing line cutting cone mechanism. Pain, weight-bearing status, and clinical examination remain the tool of choice for surgeons in decision making.
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Srinivasan, S., Bishnoi, A., Ramsingh, V.K. (2023). Defining the Clinical and Radiological Endpoint of a Successfully Fixed Fracture. In: Banerjee, A., Biberthaler, P., Shanmugasundaram, S. (eds) Handbook of Orthopaedic Trauma Implantology. Springer, Singapore. https://doi.org/10.1007/978-981-19-7540-0_3
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DOI: https://doi.org/10.1007/978-981-19-7540-0_3
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