Bone callus is formed during bone fusion. It can be of four types.
Intermediary callus is formed between tightly contacting bone fragments, if the maximum immobility of their fragments is observed. This space is filled with Haversian cells and sprouting vessels. This is how true bone healing takes place.
While maintaining the mobility of the fragments, as well as diastasis, the germination of blood vessels becomes significantly complicated, if at all possible. In this case, bone marrow is represented by the following species: paraossal, periosteal, endosteal.
Paraossal corn is formed from soft tissues that are adjacent to the fracture site. Such bone marrow is more pronounced if these tissues were significantly injured during a fracture or directly during the treatment itself. Paraossal callus is a kind of jumper or “bridge” thrown between bone fragments. Sometimes it can reach significant sizes, but this does not guarantee the strength of the adhesion.
If normal bone marrow did not form after the fracture, then development of paraossal callus fractures is possible even with minor loads.
Periosteal corn is formed by the propagation of cambial cells of the periosteum, which are well supplied with blood and have good regenerative abilities. Such bone marrow is located outside the bone.
The endostal callus is formed from endostal cells, as well as bone marrow cells. It is located inside, from the side of the bone marrow canal .
When creating favorable conditions for bone fusion, the formation of periosteal and endosteal calluses first occurs, which ensure that bone fragments are held motionless until an intermediate callus is formed, after which they are reduced. The corpus callosum then changes to take on the structure of a normal bone. This fusion is optimal: the best bone restoration is achieved in the shortest possible time.
If the displacement of the fragments is preserved, then the fusion occurs due to the periosteum with the formation of periosteal callus. Diaphyseal fractures in the process of corn formation go through the stage of cartilaginous tissue, but healing of the cancellous bone takes place without it: connective tissue callus is transformed immediately into bone and periosteal callus is not expressed.
So how should bone marrow be treated? Treatment must be carried out to eliminate the fracture, so that an intermediate callus forms, which, after reconstruction, is transformed into a normal structure bone. Final transformation takes about a year.
To treat a fracture, reposition of bone fragments, their strong fixation throughout the entire period of fusion, as well as auxiliary methods: physiotherapy, physiotherapy, massage, which are aimed at restoring the full functioning of the damaged structure, are necessary. In addition, primary treatment of the wound plays an important role in the treatment of open fractures.
Reposition and fixation are performed using conservative and surgical methods. Conservative treatment of fractures is carried out both on an outpatient basis and in a hospital (this is determined by the nature of the fracture), promptly - only in a hospital. Both of these methods are widespread in traumatological practice, their use is due to clear indications in each case.
Reposition of fragments is carried out either manually or by traction. After reaching the normal state of the fragments, immobilization is carried out, most often with a plaster cast.