Mechanism of bone repair

Bone break or fracture leads to haematoma formation from the vessels of the periosteum, endosteum and surrounding soft tissues. An acute inflammatory response ensues that comprises: Arrival of systemic factors: e.g. platelet-derived growth factor (PDGF); Arrival of phagocytic cells;

Formation of clots; Demineralisation of bone. Simultaneously, the following processes ensue: Mesenchymal cell attraction; Mesenchymal cell multiplication; Stem cell differentiation into chondrocytes; Hypertrophy of chondrocytes; Cartilage mineralisation; Osteogenesis.

Bone repair may be primary (without callus formation), which is obtained with stable rigid bone fixation with close approximation of the bone ends, or secondary (with abundant callus formation), which is the usual process.

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