10. Fracture Healing and Complications of Fractures

  1. Andrea Donovan MD2 and
  2. Mark Schweitzer MD3
  1. Marcos Loreto Sampaio

Published Online: 22 OCT 2012

DOI: 10.1002/9781118551691.ch10

Imaging Musculoskeletal Trauma: Interpretation and Reporting

Imaging Musculoskeletal Trauma: Interpretation and Reporting

How to Cite

Sampaio, M. L. (2012) Fracture Healing and Complications of Fractures, in Imaging Musculoskeletal Trauma: Interpretation and Reporting (eds A. Donovan and M. Schweitzer), John Wiley & Sons, Ltd, Oxford. doi: 10.1002/9781118551691.ch10

Editor Information

  1. 2

    Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada

  2. 3

    Department of Diagnostic Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, Canada

Publication History

  1. Published Online: 22 OCT 2012
  2. Published Print: 10 DEC 2012

ISBN Information

Print ISBN: 9781118158814

Online ISBN: 9781118551691

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Keywords:

  • bone scintigraphy;
  • Computed Tomography (CT);
  • delayed union;
  • fracture healing;
  • infection;
  • Magnetic Resonance (MR) imaging;
  • malunion;
  • nonunion;
  • radiographs

Summary

There are three phases of fracture healing: inflammatory, reparative, remodeling. Fracture healing is influenced by local and systemic factors. In delayed union, the rate of healing is slower than normal, caused by either infection, decreased vascular supply or inadequate immobilization at the fracture. Nonunion is characterized by cessation of fracture healing, usually defined as occurring 6 to 9 months after injury. Malunion refers to non-anatomic or inadequate mechanical healing of a fracture. Follow-up radiographs are useful for early detection of abnormalities in fracture healing. Computed Tomography (CT) is helpful to assess osseous bridging in complex fractures and small bones. Magnetic Resonance (MR) and bone scan may differentiate among different types of nonunion. Fracture healing has a predictable temporal pattern of appearance on bone scintigraphy. Fracture complications may occur acutely following a fracture, subacutely (during expected fracture healing period) or late (after expected fracture healing period).