Page 47 - Orthopedic Casting Manual

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.
II. Systemic Factors
A. Nutritional Status
• Descr iption: Adequate intake of nutr ients, such as c alcium, vitamin D, and protein, is crucial for bone rep air.
• Imp act: Deficiencies in c alcium and vitamin D imp air mineralization.
• Protein deficiency slows c allus for mation and collagen synthesis.

B. Hor monal Influences

• Descr iption: Hor mones regulate bone metabolism and he aling processes.
• Imp act: Positive effect: Parathyroid hor mone LPTH) stimulates bone remodeling.
• Negative effect: Excessive cor ticosteroids inhibit osteoblast function and bone for mation.
C. Smoking and Alcohol Use

• Descr iption: Tob acco and alcohol negatively affect bone he aling by al ter ing cellular and vascular dynamics.
• Imp act: - Smoking reduces oxygen deliver y and inhibits osteoblastic activit y.
• Chronic alcohol consumption disrupts c alcium metabolism and osteoblast function.

D. Comor bidities
• Descr iption: Chronic he al th conditions c an delay bone he aling.
• Imp act: Diabetes mellitus: Imp airs vascular it y and incre ases the r isk of infection.
• Rheumatoid ar thr itis: Cre ates a pro-inflammator y environment that hinders he aling.
• Chronic kidney dise ase: Al ters c alcium-phosphorus b alance, imp air ing bone strength.

E. Medic ations

• Descr iption: Cer tain drugs c an influence bone he aling.
• Imp act: Positive: Bisphosphonates (used in osteoporosis) may improve bone densit y.
• Negative: NSAIDs and glucocor ticoids c an delay he aling by reducing inflammation necessar y for c allus
for mation.

F. Infection
• Descr iption: Infection at the fracture site c an severely disrupt he aling.
• Imp act: Le ads to chronic osteomyelitis or delayed union.
• Requires aggressive tre atment, including antibiotics and surgic al debr idement.