Bone callus: norm or pathology?

The callus is formed when the bone is joined. It can be of four types.

Intermediary corn is formed between tightly contacting fragments of bone, if the immobility of their fragments is observed. This space is filled with cells of Havers systems and sprouts vessels. This is the true healing of the bone.

With the preservation of mobility of fragments, as well as diastase, vascular germination becomes significantly complicated, if at all possible. In this case, the callus is represented by the following species: parasomal, periosteal, endosteal.

Parasomal callus is formed from soft tissues, which adjoin the site of fracture. Such a callus is more expressed if these tissues were significantly injured in the course of the fracture or directly during the treatment itself. Parasomal corn is a kind of jumper or "bridge", thrown between the bone fragments. Sometimes it can reach considerable sizes, but this does not guarantee the strength of the fusion.

If normal callus after fracture did not form, then the development of fractures of parasol canal, even with minor loads, is possible.

Periostal corn is formed by the multiplication of cambial cells of the periosteum, which are well supplied with blood and have good regenerative abilities. Such a callus is located outside the bone.

Endostal callus is formed from endosteal cells, as well as bone marrow cells. It is located from the inside, from the side of the bone marrow channel .

When creating favorable conditions for bone adhesion, first the periosteal and endosteal bone calluses are formed, which ensure that the bone fragments are held motionless until an intermediary callus is formed, after which they are reduced. Intermediary callus then changes, taking the structure of normal bone. This fusion is optimal: the best bone repair is achieved in the shortest possible time.

If the displacement of the fragments is preserved, the fusion takes place at the expense of the periosteum with the formation of periosteal corns. Diaphyseal fractures in the corn formation process pass the stage of the cartilaginous tissue, but the healing of the spongy bone passes without it: the connective tissue corn is transformed immediately into the bone and the periosteal callus is not expressed.

So how should bone callus be treated? Treatment should be carried out to eliminate the fracture, to form an intermediate corn, which after transformation is transformed into a bone of normal structure. The final transformation takes about a year.

To treat the fracture, reposition of bone fragments, their firm fixation during the entire period of adhesion, and also auxiliary methods are necessary: physiotherapy, physiotherapy exercises, massage, which are aimed at restoring the full functioning of the damaged structure. In addition, primary treatment of the wound plays an important role in treating open fractures.

Reposition and fixation are carried out with the help of conservative and operational methods. Conservative therapy of fractures is carried out both outpatiently and in a hospital (this is determined by the nature of the fracture), operatively only in the hospital. Both methods are widely used in traumatology, their use is due to clear indications in each case.

The reposition of the fragments is carried out either manually or by stretching. After reaching the normal state of the fragments, immobilization is carried out, most often with a plaster bandage.