Health guide:
1. Exercise to strengthen the body: We should actively persist in exercise for a long time, increase outdoor activities, breathe more fresh air, and promote systemic blood circulation and metabolism. You can choose walking, jogging, Tai Ji Chuan, aerobics and other projects. More activities can make more calcium in the blood stay in the bones, thus improving the hardness of the bones and effectively reducing the occurrence of fractures.
2. More sunshine: sunlight can promote the synthesis of vitamin D, and the metabolism of calcium depends on the role of vitamin D; Ultraviolet rays in sunlight can promote the formation and absorption of calcium in the body, maintain normal calcium and phosphorus metabolism, increase calcium in bones and improve bone hardness.
3. Take preventive measures before getting sick: the elderly should not go to places where there are many people and cars. Don't go out when it rains, snows or there is water or ice on the ground, so as not to fall and break. Don't climb stairs or climb mountains, and don't walk on steep slopes, because the elderly are weak, unresponsive and prone to fall. When you go out, you must walk slowly. If you have dizziness, deafness, dizziness and other symptoms, you should try to reduce going out. When you have to go out, you should be helped to walk or walk with crutches. Before going to the toilet at night, you should sit on the edge of the bed for a while, so that the leg muscle strength is in an excited state to prevent the occurrence of temporary hypotension when the body position changes. When taking a bath, prepare a small stool, wear pants and shoes to prevent falling.
Diet adjustment: Eating more vegetables, protein and a diet rich in vitamins can prevent the occurrence and development of osteoporosis. The diet should be light in the early stage of fracture, which is conducive to removing blood stasis and swelling, and heavy in the later stage. Choosing a proper diet to supplement liver and kidney is beneficial to fracture healing and functional recovery.
5. Close observation: After the injury, if you suspect a fracture, you should go to the hospital for treatment in time. Necessary temporary fixing measures should be taken during the transfer. If the upper limb fracture is fixed with a wooden board, the length of the wooden board should exceed the upper and lower articular surfaces of the fracture site. You can also tie the broken arm and chest together and fix it. For lower limb fractures, the affected limb can be tied together with long wooden boards, the length of which exceeds the heel from armpit to bottom, or the affected limb can be tied together with another healthy limb for fixation. Spinal fracture should be moved to the board by two people in parallel and tied and fixed. For cervical vertebra fracture, sandbags should be placed on both sides of the head before being sent to the hospital to limit the head movement. If there is bleeding, the wound should be temporarily bandaged with a clean cloth and then bandaged with a tourniquet. Generally, the ligation time of tourniquet should not exceed 1 hour at a time, and the tourniquet can be loosened 1 ~ 2 minutes every1hour to see the blood flow, which can prevent limb ischemia and necrosis caused by too long ligation time. After fracture fixation with plaster and other methods, it is necessary to closely observe the changes of skin color and swelling at the injured limb end within 24 hours. If the swelling is aggravated and the skin is bruised and purple, you should see a doctor immediately, relax or remove the plaster to prevent limb ischemia and poor reflux caused by too tight plaster fixation. The fixed period of fracture should be reviewed regularly according to the doctor's advice.
Functional exercise: under the guidance of a doctor, actively exercise uninjured joints, every hour 100 times a day, to avoid joint stiffness, contracture and muscle atrophy. Self-massage combined with light massage can promote local blood circulation and is beneficial to the recovery of fracture.
Deputy Chief Physician of Donghua Orthopaedics
People who are suddenly injured and fractured, especially those who are in shock or even coma, have no greater mental burden psychologically. The conscious wounded, in the absence of preparation, suffered great pain, fell into extreme tension, and some felt uncertain about life and death and were very scared. At the scene of the accident, rescuers and the families of the wounded must remain calm and calm. On the one hand, we should try our best to rescue as soon as possible and try to send it to a nearby hospital. At the same time, comfort the wounded and relax. For those who are seriously injured. Use words, eyes and body movements to encourage them to be strong and eliminate despair. You know, panic, crying and tears are all malignant stimuli to the injured.
After the fracture patients are admitted to the hospital, they should also pay attention to psychological treatment and nursing during the first aid. Some doctors and nurses confess their illness in front of the patient's leaders or family members, saying that treatment is difficult and they will be disabled, and even say that they are dying and hopeless. This may be true, but it seriously hurts the patient's psychology and violates medical ethics. Even if it is critically ill, it should be explained separately to the unit and family. Medical staff should make patients feel trusted and safe through their own image and language. Patients should be comforted. Although his illness is very serious, it is not hopeless. It is unfortunate to be injured, but it is lucky to be admitted to the hospital alive.
After the initial treatment, the wounded may have a sense of psychological security and feel better, but most of them are afraid of pain and surgery. Pain is inevitable in early and late fracture reduction or surgical treatment. The more afraid you are ideologically, the more sensitive you are. Especially the groans and cries of other patients in the ward will irritate each other. At this time, the family members of patients should not excessively accommodate the unreasonable demands made by patients on medical staff. You can reflect the changes of the illness to the medical staff, at the same time give the patients spiritual comfort, and talk to them about things unrelated to the injury, so as to distract attention and reduce the pain. You should also look natural when visiting patients. If you pull a long face, patients will think that their condition has worsened, and the consequences will be bad, and a calm mood will easily lead to depression.
Some patients are anxious for the fracture to heal immediately after injury, "eager to seek medical treatment", seeking medical treatment everywhere and using drugs indiscriminately may interfere with the treatment process. In this regard, it is best for doctors to formulate a treatment plan as soon as possible, inform patients and their families, and make appropriate explanations. Fractures are different from ordinary flesh wounds, and stitches can be removed in a few days after suture. Different parts and types of fractures have different treatment time, but generally speaking, the treatment time is relatively long, ranging from 1 month to more than half a year. Let the wounded have a plan in mind and arrange their work and life reasonably.
The disability rate and deformity rate of fractures are high, some of them fully recover, and they may also leave trauma or surgical scars, which have a great impact on the appearance of the body. Patients, especially young women, are often particularly concerned about this. Sometimes I am unhappy about it and even lose confidence in life. Some patients worry that their disability will affect their career, marriage and family. So they frown all day; Some people become irritable. Medical staff should do a good job of explanation, and family members and relatives should also understand patients and be considerate from all aspects to comfort them: "Why worry about not burning firewood?" Don't worry too much. As long as it is treated in time and hard functional exercise is carried out in the future, it can return to normal and make up for the loss. Even if the injury left some sequelae and caused some losses, it can be minimized. For the wounded who are left paralyzed or physically disabled, we should use the deeds of Chinese and foreign celebrities and heroes, such as Pavel Colta King, Wu Yunduo, Zhang Haidi, etc., to inspire them, face the reality, establish confidence in overcoming disability, and ensure that the disabled are not disabled.
After the fracture enters the recovery period, the joints often become stiff after removing the plaster or splint, and feel pain or swelling after a little activity. Due to long-term inactivity, the muscles of limbs atrophy and the girth becomes thinner. Many patients are worried about whether they can recover, and some people speculate that the doctor has cured them. I'm afraid I'll be disabled for life, so I'm on tenterhooks all day and don't think about tea and rice. In fact, this situation is a normal phenomenon in the process of recovery, which can be explained to patients. This is caused by the adhesion inside, between muscles and around muscles when the joints are fixed, which may be eliminated after a period of rehabilitation exercise.
Functional exercise in the recovery period of fracture is very important and quite painful. Many patients are afraid of pain and difficulties, and some patients pin their hopes on drugs and medical devices. Some relatives and friends of fracture patients, starting from their feelings, refused to let them suffer, disobeyed functional exercise, waited passively and did not practice for a long time. It must be understood that some pain and swelling reactions are normal at the beginning of exercise. Functional exercise is the only way for limb rehabilitation, which can't be replaced by any oral, smearing and advanced instruments. If you don't practice today, you won't move tomorrow. The pain will continue and the swelling will go away. Family members should encourage patients to help overcome their fear of difficulties, and also praise and encourage small progress.
In addition, we must overcome the psychology of being eager for success. Some patients can't wait to remove the plaster and splint today and be free to move tomorrow. Some quack "doctors" cater to the psychology of these people, pulling the stiff joints with rough force, causing injuries and bleeding inside and outside the joints. If it causes pain, it will also cause serious adhesion and affect the therapeutic effect. Never fall for it.
Xu Donghua, fracture internal fixation instrument
The treatment of fractures can be divided into two categories. The first kind is to combine broken bones in various ways, and then fix and protect the skin with plaster or splint to heal the fracture. Here, plaster and splint are external fixation devices. If this method can't be used, "or the effect is not good, the second method-surgical treatment is needed: the doctor cuts the skin, aligns the broken bones accurately under direct vision, and then fixes them with bone plates, screws, steel needles and other bone-setting equipment. These bone fixation devices are internal fixation devices.
After the fracture healed completely, the internal fixation instrument lost its function. Is it better to leave the internal fixation device in the body or take it out at this time? After repeated tests and selection, the metal used to make internal fixation instruments is safe and non-toxic to human body and has good compatibility. However, they are fundamentally different from the living tissues of the body. After all, it is a foreign body, and staying in the body for a long time may cause a variety of adverse reactions.
First, it can induce delayed infection. Pathogenic microorganisms, such as bacteria, can often enter the human body with slight trauma to skin and mucosa and low local resistance. The living tissue of the body is covered with capillaries, which contain white blood cells that recognize and attack pathogens, and can quickly annihilate pathogens. Hard steel plates and needles placed in bones, because they have no blood vessels and lack this resistance, can easily become hiding places for bacteria. Bacteria grow and multiply, leading to infection.
The second is to cause osteoporosis nearby. The basic functions of bones are protection, support and movement, in short, stress. Within a certain range, the more stress, the stronger. Internal fixation equipment, especially steel plate, has the function of stress shielding. It bears the stress that the bone should bear, which is conducive to maintaining posture and restoring motor function in the early stage of fracture. But after the fracture healed, it had shortcomings. Due to the lack of stimulation, the nearby bones will become looser and looser. Osteoporosis is too loose, and the screw needle is not fixed firmly, which will lead to another fracture.
Thirdly, the internal fixation instrument placed outside the bone will stimulate the soft tissue and produce complications such as bursitis. For example, the tail of intramedullary nail used for femoral fracture is located on the deep surface of hip skin and muscle. Due to joint fracture activity, synovial sac inflammation can be formed on the surface, resulting in hydrops, which can cause pain or limit joint activity. In some cases, if the internal fixation device for children's fractures is not removed for a long time, with the growth and development of children, the position of the internal fixation device may change, compressing nerves and blood vessels, causing serious complications such as paralysis or hemangioma.
Fourth, individuals can have electrolytic reactions. Human blood, lymph and tissue fluid contain various ions, which are electrolyte solutions. Although the chemical properties of internal fixation steel plate are quite stable, it will also cause obvious electrolytic reaction over time, leading to tissue edema. Therefore, the internal fixation instruments for fractures should generally be taken out at an appropriate time after fracture healing. This timing is very particular. The time of fracture healing is related to the location and type of fracture, the patient's age, nutritional status and treatment methods, ranging from one month to more than half a year. But this does not mean that once the fracture heals, the internal fixation device should be taken out immediately. Early callus is hard osteoid, mostly spindle-shaped, covering the broken end of the fracture. Its appearance is rough, its internal structure is chaotic and its firmness is poor. It is too early to remove the internal fixation instrument at this time.
With the continuous movement and exertion of joints, the bones of those parts with great stress gradually harden, while the redundant callus is destroyed and absorbed by osteoclasts. After this transformation, the broken bones are fused up and down, which is very strong. At this point, the internal fixation equipment can be removed. The exact timing should be decided by the doctor. Except those that cause complications, in principle, it is better to postpone appropriately than advance. Pressurized steel plates are very strong. After fixation, it bears most of the stress of the bone, and the shaping period after fracture healing is often longer, so it is easy to fracture again when the steel plate is taken out early. Therefore, the removal time is longer than that of ordinary steel plates. Foreign experts suggest that the time to take out the internal fixation device is: tibia 1 year, femur 2 years, forearm bone and humerus 1.5-2 years. Individual patients with high surgical risk or elderly patients can also be temporarily removed and observed for a long time.
In a few cases, the position of internal fixation instruments is just close to nerves and blood vessels, and the anatomical level of the second operation is not as clear as that of the first operation, which increases the chance of injury. In addition, because the bone grows too fast, or the tail groove of the screw is damaged and shallow, or the nail, needle and steel wire are broken, it is difficult to find the internal fixation instrument, and it is troublesome to take it out, or even impossible to take it out. Experienced orthopedic surgeons will handle it appropriately according to the specific situation of patients. Generally speaking, the operation of taking out the internal fixation instrument is generally easier and shorter than the first contraposition fixation.
Finally, it should be mentioned that after years of exploration, the fracture internal fixator that can be absorbed in the body has been successfully manufactured, and now many hospitals are promoting its application. This material is a polymer organic compound, which is non-toxic to human body. Use it to fix broken bones. As the fracture heals, it will slowly degrade itself and become carbon dioxide and water. The use of this internal fixation device can be "once and for all" in one operation, and patients do not have to take the risk of a second anesthesia operation.
Daily health news editorial department of free hospital network www.cmn.com.cn2000/12/18.
Zhang Jishuitan Hospital Orthopedic Attending Physician
I. Definition
Bone or cartilage loses its integrity or continuity, which is called fracture.
Second, the cause of the fracture
(1) Traumatic fracture: The integrity of bones is destroyed by violence, which is called traumatic fracture. This is the most common cause of fracture. According to the different ways of violence, it can be divided into three types:
1. Direct violence: violence directly acts on the fracture site.
2. Indirect violence: violence acts on parts far away from fractures and is transmitted through bones, joints, muscles or ligaments, leading to fractures in some parts.
3. Repeated violence: Repeated violence on the same part can gradually lead to fractures, also known as fatigue fractures. Such as fractures of the second and third metatarsals, tibia, femur, fibula or femoral neck after long-distance marching or repeated exercise.
(2) Pathological fracture: A fracture caused by systemic or local pathological changes of the bone itself is called a pathological fracture.
Third, the classification of fractures.
(1) According to the shape of fracture line, it can be divided into horizontal, oblique, spiral and crushed shape.
(2) According to the fracture site: diaphysis fracture, intra-articular fracture and epiphyseal injury, etc.
(3) According to the degree of fracture: complete fracture and complete fracture, the latter is also called green branch fracture.
(4) Whether the fracture ends are connected with the outside world: it can be divided into closed fractures and open fractures.
(5) Time after injury: fresh fracture-fracture within 3 weeks after injury. Old fracture-more than 3 weeks after injury.
Fourth, fracture treatment.
The ultimate goal of fracture treatment is to restore the normal function of the injured part as soon as possible. Therefore, we should choose the simplest, most thorough and most beneficial treatment for fracture healing and functional recovery. Reduction, fixation and functional exercise are the basic measures to treat fractures.
Five, the first aid of fracture
First aid of fracture is immediate treatment after fracture, including examination, diagnosis and necessary temporary measures. First aid for fracture is very important. Improper treatment will aggravate the injury, increase the pain of patients, and even cause disability and affect their lives. Therefore, it is very important to carry out reasonable and effective first aid in time. First aid should be given at the scene. First of all, we should simply understand the injury, first check the vital signs and then check the local injury to determine the nature, location and scope of the injury. Observe whether there is respiratory obstruction, dyspnea, cyanosis and abnormal breathing; Pay attention to whether the patient has shock; Whether there is wound bleeding and internal bleeding; Pay attention to the patient's mental state, whether there are signs of pupils, eyes, ears, nosebleeds and craniocerebral injury; Whether there is visceral injury in the chest, abdomen and pelvic cavity; Whether there is spinal cord, peripheral nerve injury and limb paralysis, pay attention to whether there is limb swelling, pain, deformity and loss of function, and determine whether there is fracture and dislocation.
Emergency treatment should include ① keeping respiratory tract unobstructed. ② Prevent shock. Patients with trauma such as severe or multiple fractures are more prone to shock, so attention should be paid to prevention, early detection and early treatment. Prevention of shock includes: relieving pain, fixing the affected limb has the functions of relieving pain, stopping bleeding, reducing tissue damage and shock; Hemostasis, internal bleeding or external bleeding are the main causes of traumatic shock, which will aggravate if it is not controlled. Generally, local pressure dressing can stop bleeding. If the bleeding of limbs can't be controlled, you can tie a tourniquet, but the position of the tie should be correct and the tightness should be appropriate, otherwise it will aggravate the bleeding. Don't tie the tourniquet for more than two hours at the longest, and relax it every hour or so, but don't risk bleeding again and relax the tourniquet easily. If possible, blood transfusion, blood transfusion and oxygen transfusion should be given immediately. ③ Temporary fixation of fractured limbs: upper limb fractures are mainly fixed with splints, suspended with triangular towels, and injured limbs are fixed on the chest wall with bandages; Lower limb fractures are mainly fixed or tied to the healthy leg with a semicircular Thomas frame, and fractures below the knee are fixed on a small splint; When spinal and pelvic fractures are suspected, the movement of the fracture site should be avoided as far as possible to avoid causing or aggravating the injury. No matter whether the patient is in supine or prone position, try to straighten his limbs without changing his original position. After preparing the hard board stretcher, the two men gently rolled the patient onto the board and lay on his back, and tied him to the stretcher with a wide cloth belt. If the fracture is located in the neck, one person must hold the chin and occipital bone for a little traction. The spine should remain neutral when rolling. It is best to put a small cloth roll under the waist or neck.
Fracture healing
Fractures can usually be divided into two categories: traumatic fractures and pathological fractures. Bone regeneration ability is very strong, and the traumatic fracture after reduction can be completely healed in 3 ~ 4 months or longer. The proliferation of osteoblasts in exoskeleton and intima and the formation of new bone are the basis of fracture healing. After the fracture, the bone healed completely through the process of hematoma formation, fiber and callus formation and callus reconstruction, so that the bone returned to normal in structure and function.
First, the process of fracture healing.
The process of fracture healing can be divided into the following stages:
(1) Hematoma formation
In addition to the destruction of bone tissue, fractures must be accompanied by injury or tearing of nearby soft tissues. Bone tissue and bone marrow are rich in blood vessels, and there is often a lot of bleeding after fracture, which fills between the two broken ends of the fracture and its surrounding tissues, forming hematoma. Hematomas usually coagulate within a few hours. Like the trauma of other tissues, slight neutrophil infiltration can be seen at the fracture site at this time.
During the fracture, the blood vessels that nourish the bone marrow, bone cortex and periosteum are broken, so within 1 ~ 2 days after the fracture, the bone marrow hematopoietic cells are necrotic, and the fat in the bone marrow is precipitated, and then surrounded by foreign giant cells, forming fat "cysts". Extensive ischemic necrosis can also occur in the cortical bone. Osteonecrosis is characterized by the disappearance of bone cells in bone lacunae and their becoming cavities under microscope. If the range of bone necrosis is not large, it can be absorbed by osteoclasts, and sometimes dead bones can fall off and form dead bone fragments.
(2) Formation of fibrous callus
About 2 ~ 3 days after the fracture, fibroblasts and new capillaries proliferated from the endosperm and periosteum and invaded the hematoma, and the hematoma began to organize. Essentially, most of these fibroblasts are precursors of chondrocytes and osteoblasts. The above-mentioned hyperplastic tissues gradually healed, filled and bridged the broken ends of the fracture, and then fibrosed to form fibrous callus, or temporary callus. The naked eye showed that the fracture was spindle-shaped swelling. After about 1 week, the above proliferated granulation tissue and fibrous tissue can further differentiate into hyaline cartilage. The formation of hyaline cartilage is generally more common in periosteal callus than in bone marrow callus, which may be related to the lack of blood supply in the former. In addition, it is also related to the excessive mobility and stress at the fracture end. But when there is too much cartilage in callus, it will delay the healing time of fracture.
(3) Bone calcium formation
The further development of fracture healing process is that osteoblasts produce new bone to gradually replace the above fibrous callus. The bone originally formed is osteoid tissue, and then calcium salt is deposited to form woven bone, that is, callus. Cartilage tissue in fibrous callus, like cartilage bone in the process of bone development, evolved into bone tissue through calcium deposition and participated in the formation of callus. The braided bone formed at this time can not meet the normal functional needs because its structure is not compact enough and the trabecular arrangement is disordered.
Callus can be divided into external callus and internal callus according to different cell sources and callus sites.
1. The external callus or periosteum callus is the proliferation of osteoblasts, and the inner layer of periosteum forms a spindle-shaped sleeve that wraps the broken end of the fracture. As mentioned above, these cells mainly differentiate into osteoblasts to form callus, but they can also differentiate into chondrocytes to form cartilaginous callus. External callus is mainly formed during long bone fracture.
2. The internal callus evolved from endosperm cells and bone marrow undifferentiated mesenchymal cells to osteoblasts, forming woven bone. Cartilage can also be formed in the medial callus, but the number is less than that in the lateral callus.
(4) Reconstruction or remodeling of callus.
After the callus is completed, the fracture ends are only connected by naive and irregularly arranged braided bones. In order to meet the physiological requirements of human body and have stronger structure and function, woven bone is further transformed into mature lamellar bone, and the normal relationship between cortical bone and medullary cavity is restored. Reconstruction is carried out under the synergistic effect of bone absorption by osteoclasts and new bone formation by osteoblasts, that is, more new bones are formed at the part where the fracture bone bears the maximum stress, and the bones needed for mechanical dysfunction are absorbed, so that the upper and lower broken ends of the fracture are reconnected according to the original relationship, and the medullary cavity is also reconnected.
In general, after the above steps, the fracture site recovered to the same structure as the original bone tissue and healed completely.
Second, the factors affecting fracture healing
1. systemic factors ① age: children have strong bone tissue regeneration ability, so the fracture heals quickly; The ability of bone regeneration in the elderly is weak, so the fracture healing time is longer. ② Nutrition: Severe protein deficiency and vitamin C deficiency can affect the collagen synthesis of bone matrix; Vitamin D deficiency will affect callus calcification and hinder fracture healing.
2. Local factors ① Local blood supply: good blood supply for fractures, rapid fracture healing, such as humeral surgical neck (upper end) fracture; On the other hand, if the local blood supply is poor, the fracture will heal slowly, such as femoral neck fracture. Fracture types are also related to blood supply: for example, spiral or oblique fractures, because of the large contact surface between the fracture site and surrounding tissues, there is a large capillary distribution area for blood supply, and healing is faster than horizontal fractures. ② Broken end state: Poor alignment of broken ends or soft tissue impaction between broken ends will delay healing and even prevent joint. In addition, if the bone tissue is seriously damaged (such as comminuted fracture), especially if the periosteum is destroyed too much, bone regeneration is also difficult. If there is too much local bleeding and the hematoma is huge, it will not only affect the contact of the section, but also affect the fracture healing with the extension of the hematoma organization time. ③ Fixation of broken end of fracture: Broken end activity can not only cause bleeding and soft tissue injury, but also often only form fibrous callus, making it difficult to form new bone. In order to promote fracture healing, good reduction and fixation are necessary. However, long-term fixation will cause disuse atrophy of bones and muscles, and also affect fracture healing. ④ Infection: Open fractures (that is, the skin and soft tissue at the fracture site are damaged and the fracture site is exposed) are often complicated with suppurative infection, which delays fracture healing.
For patients with fracture healing disorder, sometimes too much new bone is formed, forming redundant callus, and obvious bone deformation occurs after healing, which affects the recovery of function. Sometimes fibrous callus can't turn into callus and cracks appear, and the two broken ends of the fracture can still move to form a false joint, or even the broken ends cover new cartilage to form a new joint.
Attached pathological fracture
Pathological fracture refers to a bone lesion, which occurs under the action of external force that is usually not enough to cause fracture, or spontaneously occurs without any external force.
Causes of common rational fractures:
1. Primary or metastatic bone tumors are the most common causes of pathological fractures, especially osteolytic primary or metastatic bone tumors. Primary bone tumors, such as multiple myeloma, giant cell tumor of bone and osteolytic osteosarcoma; Metastatic bone tumors, such as metastatic kidney cancer, breast cancer, lung cancer, thyroid cancer and neuroblastoma. Many primary and metastatic bone tumors are sometimes found after pathological fractures.
2. Osteoporosis Old age, various malnutrition, endocrine and other factors can all cause systemic osteoporosis, which is characterized by atrophy and thinning of bone cortex, thinning of bone trabecula and reduction in number. It mainly affects the spine, femoral neck and metacarpal bone. Thoracolumbar compression fractures, fractures of femoral neck, upper humerus and lower radius are more common in elderly women, especially postmenopausal women. Limb paralysis, long-term fixation or long-term illness in bed can cause local disuse osteoporosis and fracture.
3. Endocrine disorder caused by parathyroid adenoma or hyperplasia Hyperparathyroidism can lead to bone decalcification and a large number of osteoclasts accumulation, and trabecular bone is replaced by fibrous tissue. At this time, although new bone is formed, it can only form fine-grained bone or uncalcified osteoid tissue, which is prone to multiple pathological fractures.
4. There are many kinds of congenital bone diseases that can lead to pathological fractures. For example, congenital osteogenesis imperfecta, an autosomal dominant genetic disease, occurs in fetus or childhood. Because of congenital mesenchymal development defects, it is difficult for osteoblasts to differentiate into osteoblasts, and it is difficult for osteoblasts to synthesize type I collagen fibers in bone matrix, so the cortical bone of long bones is thin and brittle, and multiple pathological fractures are prone to occur, so it is also called brittle bone syndrome. However, the newly formed callus after fracture is cartilaginous or fibrous and is not easy to ossify.
When pathological fractures occur, the original lesions of bones often make the fracture heal slowly, or even have little repair response. It also often changes or complicates the histological image of the original bone injury.
"After sitting for a day, I feel stiff and stiff from my nec