Page 46 - Orthopedic Casting Manual

4.3 Factors Affecting Bone Healing

Bone he aling is influenced by a var iet y of factors that c an either enhance or hinder the process. These factors
c an be bro adly c ategor ized into biologic al, mechanic al, and systemic influences.

I. Biologic al Factors
A. Age

• Descr iption: Bone he aling c ap acit y decre ases with age due to reduced cellular activit y and slower metabolic
rates.
• Imp act: Children: Faster he aling due to active growth plates and high osteoblastic activit y.
• Elder ly: Slower he aling due to reduced osteoblast function and diminished vascular it y.

B. Type and Severit y of Fracture

• Descr iption: Complex fractures, such as comminuted or open fractures, take longer to he al than simple,
closed fractures.
• Imp act: Open fractures: Incre ased r isk of infection and delayed he aling.
• Displaced fractures: May require surgic al inter vention for proper alignment.

C. Vascular Suppl y

• Descr iption: Adequate blood flow is cr itic al for deliver ing nutr ients, oxygen, and growth factors to the injur y
site.
• Imp act: Poor vascular it y (e.g., in sc aphoid or femoral neck fractures) c an le ad to avascular necrosis or
delayed he aling.

D. Soft Tissue Integrit y

• Descr iption: Damage to sur rounding soft tissues c an impede bone he aling by disrupting the vascular supply
and cre ating an inflammator y environment.
• Imp act: Severe soft tissue injur y incre ases the r isk of infection and complic ations, delaying the he aling
process.

E. Bone Qualit y

• Descr iption: Conditions affecting bone qualit y, such as osteoporosis, osteopenia, or Pagetʼs dise ase, imp air
the structural integr it y of bone.
• Imp act: We akened bone structure resul ts in slower he aling and higher r isk of nonunion.

Conclusion Bone he aling is a remar kable biologic al process involving inflammation, rep air, and remodeling. Each
stage plays a vital role in restor ing the boneʼs integr it y and function. For he al thc are professionals, understanding
the intr ic acies of this process is crucial for effective fracture management and p atient c are. By recognizing the
factors that influence bone he aling and tailor ing inter ventions accordingly, clinicians c an optimize outcomes and
suppor t p atients on their jour ney to recover y.