Can a broken tibia heal in 4 weeks

The simple answer to this would be – it varies! To understand this better, we need to know more about bone fractures and bone healing.

What is a fracture and why does it happen?

Bones are a kind of connective tissue that is reinforced with bone cells and calcium. Bone cells are of four types; osteoclasts, osteocytes, osteoblasts and bone-lining-cells. The body is constantly strengthening and remodeling the bones by creating new bone cells. Certain diseases like bone cancer and osteoporosis can weaken the bones and make them brittle, so such people become more vulnerable to fractures. This is especially true of women who have crossed their menopause and elders with weak bones and lower muscle-mass.

Other than this, sporting injuries, vehicle accidents, falls from heights and workplace injuries can also cause bones to break. For that matter, bones are quite strong but when the impacting force is higher than what a bones can bear, the tissues give way, creating a crack, a deep split, a displacement or division of the bone. Blood vessels in the bone at the site of fracture also get ruptured causing bleeding.

Types of Bone Fracture

• Stress fracture: a thin crack, also called a hairline fracture, across the length or width of the bone
• Transverse fracture: there is a clear breakage straight across the bone
• Oblique fracture: The bone breaks at an angle
• Greenstick fracture: Here, there is one or more breaks on one side, and bends on the other side – (compared to a fresh stick that is broken from a tree)
• Comminuted fracture: Here the bone breaks into multiple pieces
• Compression fracture: These fractures happen often in the spine and hence called spinal fractures
• Avulsion fracture: Here, a tendon or ligament is pulled off a piece of bone

Symptoms of bone fractures

• If the fracture is deep or comminuted, the person may lose consciousness for some time
• Feeling chilly, dizzy, or something is just not right
• At the site of fracture, there may be swelling, bruising, stiffness and warm feeling
• Weakness at the site
• Inability to use or move that body part
• One or more bones don’t look right, like they are bent in an odd angle

 Complications from bone fracture

 Normally, the human body can heal or repair a bone fracture on its own. However, it’s risky to do so, and a doctor’s intervention is always required, no matter how minor the break. This is because, left on its own, the healing bone may be displaced from its original position or bent. There may be abnormal healing (excessive or lesser bone tissue), loss of function or weakness in that bone. This can be prevented by consulting a qualified orthopedic doctor who will use the right techniques to manipulate or ‘set’ the healing of the bone in the right direction.

If fractures are not treated properly, there can be other complications such as:

• infection from the injury that can spread to other parts of the body
• joints near the fracture can swell up due to bleeding from the fracture
• blood clots can form in blood vessels near the fracture and travel through the body causing newer complications
• skin, tissues, or muscles surrounding the fracture can be damaged

How are bone fractures treated?

• Traditional cast: Here, the broken bone is enveloped in a rigid cast made of specialized plaster of Paris, with an intention of immobilizing the bone. This way, it’s not strained in any way throughout the healing process and can heal correctly. This is the most preferred type for fractures in the hands, legs, wrists and feet.
• Functional cast or brace: Here in the first stage, a rigid cast like the one described above is put. This stabilizes the bone but makes it immobile. After some time, the cast is removed and a functional brace is put which allows for some movement or flexibility of the bone and bone joint.
• Surgery: If the fracture is severe, multiple, complex and not suitable for a cast, then, surgery may be the only option. The procedure is called Open Reduction. Here, a surgeon will expose and reposition the bone by hand. There are 2 types under this procedure:

1. Open Reduction with internal fixation: Special screws or metal plates are fixed to the outside of the bone pieces to hold them together. Sometimes, a metal rod is also inserted through the pieces to hold them together.
2. Open Reduction with external fixation: This is more complex and performed by an orthopedic surgeon under a general anesthetic. Here, holes are drilled into the healthy part of the bones around the fracture and special bolts screwed into the holes. The bolts extend out of the body, and outside of the body, special rods with ball-and-socket joints are fastened to the bolts. Adjustments can be made from time to time, to the ball-and-socket joint, to ensure the bone is getting aligned properly with no reduction in length. The skin at the piercings will be cleaned regularly to prevent infection. The doctor may even choose to put a cast there. The bolts and external frame are removed later in a doctor’s office with no anesthesia. Fractures can occur at the site where holes were drilled into the bone, so one must be careful for a couple of months, after the external device has been removed.

How long does healing take?

Normally it takes 6-8 weeks for bones to heal completely in other parts of the body. When it comes to large or heavy bones like the femur (thigh-bone) and tibia (shin-bone), it could take as long as 20 weeks (5 months). Age, general health and overall bone health also affect the healing time.

Bone healing goes through 3 phases:

1. Inflammatory phase: After 48 hours of the fracture, blood vessels torn by the fracture release blood and this in turn triggers clotting of blood at the site which is called a fracture hematoma. The hematoma disrupts blood flow to the area, so some bone cells die. This process ends in a week from the day of fracture.
2. Reparatory phase: This process happens in parallel with the above phase. Within 1 or 2 days after the fracture, this phase starts and lasts for 2-3 weeks. In this, cartilage and tissue develop in and around the fracture area. Soft tissue called callus starts growing at both ends of the breakage, till they meet. This helps stabilize the bone. These soft calluses are soon replaced by a spongy bone tissue called trabecular bone.
3. Remodeling phase: In this phase, solid bone tissue replaces the spongy trabecular bone tissue. For a few days, the outside of the bone may show some swelling which will go away on its own.

What can be done to speed up healing?

1. Protein supplements: A doctor will prescribe protein supplements. This helps as bone tissue is largely made up of protein.
2. Anti-oxidants: these help fight free radicals generated by the fracture. Anti-oxidant supplements prescribed by a doctor contain Vitamin C, Vitamin E, alpha-lipoic acid and lycopene.
3. Vitamin supplements: Vitamins accelerate bone healing as most of the cellular processes that happen in a bone are driven by them. Supplements are given that contain Vitamins B, C, D and K. Vitamin B promotes energy production.
4. Mineral supplements: Bones contain rich quantities of zinc, calcium, magnesium, silicon and phosphorus. Supplements that contain these minerals accelerate the healing process.
5. Exercise: The doctor will prescribe specific exercise at every stage of the healing process. These speed up bone healing, improve blood flow to the healing area and help rebuild muscle mass there.
6. Avoiding smoking: Since smoking can reduce blood flow in tiny capillaries anywhere in the body including bones, the person must avoid smoking during the healing process.

Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem and Bengaluru, the hospital also renders adult and pediatric trauma care.

Chennai – 044 4000 6000 • Trichy – Cantonment – 0431 4077777 • Trichy – Heartcity – 0431 4003500 • Trichy – Tennur – 0431 4022555 • Hosur – 04344 272727 • Salem – 0427 2677777 • Bengaluru – 080 6801 6801

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