Bone histology & Repair

8/9/2019 Bone histology & Repair

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Seeing much, suffering muchSeeing much, suffering much

and studying much are theand studying much are thethree pillars of learning.three pillars of learning.

Benjamin Disraeli


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Bone Histology &Bone Histology &Fracture HealingFracture Healing


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Bone Anatomy Diaphysis

Metaphysis

Epiphysis Prox/Dist

Epiphyseal line

Periosteum Compact cortical bone

Spongy bone

Articular Cartilage

Meullary ca!ity

Marro"

#utrient artery


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Bone Formation:

$ntramembranous Enochonral

Bone Growth:

$nterstitial%ppositional

Bone Function:

Mineral homeostasis&

'emopoiesis&

ey !ords:

Minerali(ation

Calci)ication

%ssi)ication

'arness

*ensile strength

+ol,mann-s canal

'a!ersian canal

.acunae

%steon

*rabeculae


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An individual at prolonged bed restquickly begins to lose bone mineral

density (BMD). Conversely, an

athlete ho engages in sports

requiring repetitive !umping and

landing is likely to have a higherBMD


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Bloo Supply to Bone


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*ypes o) Bone tissue

!o"en #one $rregular immature )etus/0

$amellar #one regular mature&Circum)erential

Concentric

$nterstitial

*rabecular

%ompact & Spongy1 lamellar bone Enchonral / intramembranous )ormation&


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Compact Bone


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*he matrix o) bone

Contains inorganic salt Calcium'yroxyapatite in collagen )rame"or,&

%steoblasts 1 Calci)ication 1 Minerali(ation

Mineralsharness

Collagen )ibres*ensile strength&

Collagen is necessary )or Calci)ication&


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%steogenic cells


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Bone 2emoeling

+itamin D

#utrition

Physical acti!ity

Age3 hormones

P*'3 P'2P $.43 *#53*6517

8149: bone / year&


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%steoclast in lacuna;


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*he 'istologic *ypes

%ompact #one

Spongy #one

$amellar #one

!o"en #one

steoid %allus


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Compact Bone

steonsor Ha"ersiansystems& %steons contain bloo !essels3 lymphatic

!essels3 ner!es3 an osteocytes along "ith

the calci)ie matrix& %steons are aligne in the same irection

along lines o) stress 1 .amellar bone&

#o osteons or B+ in trabecular bone&


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Compact

Bone

Bone

Does not contain osteons& trabeculae surrouning re marro" spaces


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Cancellous bone =Polari(ation&M>


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Enochonral %ssi)ication ?ithin cartilage& $nterstitial gro"th& Cells

s"ell3 burst3 replace by osteocytes "ith Ca@


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Enochonral %ssi)ication Seconary ossi)ication 1 epiphysis

Articular cartilage an epiphysial plate 1


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Membranous %ssi)ication S,ull3 manible3 cla!icle&

5ibrous membrane3 %s& center3 trabeculae


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%steoblasts


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6ro"th plate


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5ractures

Brea, in the bone& Simple / Compoun in)ection&

Single 1 'ori(ontal3 obliue3 spiral3

Comminute multiple& 6reenstic, partial chilren&

*orus compression o) cortex chilren&


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*ypes o) 5racture


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'ealing in Bone

'( ) Hematomaformation *fi#rin mesh+

( ) -nflammation /(GF, -$, 0GF

'! ) Softcallus granulation, matri1.

)2! ) %allus ossification, wo"en #one

34! )5e)modeling a#sor#6deposit,

strength, lamellate.


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Stages of wound healing

Time a"ter in#ury

Hemostasis

Inflammation

Proliferation

Resolution/ Remodeling

P$%s& $acrophages& 'ymphocytes

eepithelialiation& *ngiogenesis& +ibrogenesis&

,essel regression& Collagen remodeling

+ibrin clot& platelet

deposition


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Stages of wound healing

Time a"ter in#ury

Hemostasis

Inflammation

Proliferation

Resolution/ Remodeling

P$%s& $acrophages& 'ymphocytes

eepithelialiation& *ngiogenesis& +ibrogenesis&

,essel regression& Collagen remodeling

+ibrin clot& platelet

deposition

'( ( 'w7 2w7 3w7


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'ealing in Bone


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'ealing in Bone


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Compoun 5racture


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5racture 'ea o) 'umerus


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$mmobili(ation Plaster cast


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Bone healing Callus


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Callus ?o!en bone


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Callus ?o!en bone


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5actors a))ecting 'ealing

Systemic & $ocal factors $mmobili(ation

$mproper reuction abnormal position

$n)ection& Debris3 ea tissue in "oun

oint in!ol!ement


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Complications

Delaye healing& #on healing&

oint in!ol!ement 1 an,ylosis

Abnormal position arthritis&

Bone necrosis nutrient artery

$n!olucrum )ormation&

Pseuoarthrosis


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$n!olucrum


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Summary < 5urther 2eaing

Bone types3 histology3 )ormation3

%steons3 'S3 lacunae3 lamellae

Calcium3 P%D3+it D3 P*' < Calcitonin3

'ealing1 stages3 )actors3 complications

Pseuoarthrosis3 in!olucrum3

Diseases

%steoporosis3 %steomalacia < 2ic,ets


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If You Fail to Plan,If You Fail to Plan,Then you plan to Fail!Then you plan to Fail!

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Bone histology & Repair