A patient is diagnosed with an oblique fracture of the left femur. In which order should the nurse explain the steps of healing?

Question

Choice 1. bony callus formation
Choice 2. fibrocartilaginous callus formation
Choice 3. hematoma formation
Choice 4. remodeling

Answer 1

Correct Answer: 3, 2, 1, 4

When a bone fractures, bleeding and tissue damage at the site of the fracture initiate an inflammatory response. A hematoma forms between the fractured bone ends and around the bone surfaces. Within 48 hours, fibroblasts and new capillaries growing into the fracture form granulation tissue that gradually replaces the hematoma. Phagocytes remove cell debris. Osteoblasts migrate to the fracture site, where they build a web of collagen fibers from both sides of the fractured bone. Chondroblasts lay down patches of cartilage as a base for bone growth. This fibrocartilaginous callus connects bone fragments, splinting the fracture and maintaining bone alignment. The third stage of fracture healing, bony callus formation, begins 3 to 4 weeks after the injury and continues for 2 to 3 months. Osteoblasts continue to form collagen fibers and bone matrix, which are gradually mineralized with calcium and mineral salts. During the remodeling phase, excess callus is removed and new bone is laid down along the fracture line. The fracture site calcifies and the bone reunites.