Posted by Orthopedics and orthopedic surgery is one of the most popular fields of medicine with it being one of fourth specialties that filled all of its available residency positions during the 2023 match process. Orthopedics is the medicinal field of study concerned with the correction of bone and muscle deformities. I first became interested in the field of orthopedics around the age of 13 when I broke the first metacarpal on my right hand. I had what is known as a Bennett’s Fracture.
A Bennett’s Fracture is an intra-articular fracture that separates the palmer ulnar first metacarpal base from the rest of the metacarpal. Bennett’s Fractures are the most common type of fracture involving the first metacarpal (Carter & Nallamothu 2023). Within a week of breaking my hand I received what is known as a closed reduction surgery, or a surgery to set my fracture without cutting my hand open. Once the metacarpal bone was set into place, the healing process began.
When a fracture occurs, a hematoma bleeds into the fracture space, providing support in the area during what is known as the inflammatory phase. Inflammatory cells then invade the hematoma and remove necrosed bone and debris. New capillaries form to help provide nutrition for the formation of fibrocartilaginous callus during what is known as the reparative phase of fracture healing. This soft callus is then converted into hard callus that can in turn be remineralized into bone during the remodeling phase. A return of medullary and periosteal blood flow also occurs during the remodeling phase. This process is known as secondary fracture healing (LaStayo et al. 2003). The steps of secondary fracture healing are illustrated in the first picture provided.
There are many different types of fractures, but only 6 common fracture types; comminuted, compression, spiral, epiphyseal, depressed, and greenstick. Comminuted fractures are fractures where the bone is fragmented into 3 or more pieces. Compression fractures occur in the spinal column when a vertebrae is crushed. Spiral fractures occur as a result of twisting forces that are applied to the bone. Epiphyseal fractures occur when the epiphysis separates from the diaphysis along the epiphyseal plate of the bone. Depression fractures occur when the broken bone is pressed inward and are common with skull fractures. The final common fracture is a greenstick fracture that occurs when a bone breaks incompletely so one side of the shaft is broken while the other bends. Each common fracture is illustrated in the second picture with a description of the fracture type and an example of where the fracture commonly occurs. Orthopedics is a very diverse field with many different options in the treatment of fractures, however the healing process at a molecular level does not have much variation. I also included an x-ray of my Bennett’s Fracture to show what it looks like.
References
Ansari, Umair, et al. “Practice Variation in Common Fracture Presentations: A Survey of Orthopaedic Surgeons.” Science Direct, 15 Dec. 2010, www.sciencedirect.com/science/article/pii/S0020138310007485?casa_token=07KDgcOM0h0AAAAA%3A427NhX3u8R_SodYTav-hBTLpSln8P5e0dqYRvOOT8mrAXgqMBWWK5ClwpseZL9TPbWBxhXJFMp-I.
Carter, Kevin R., and Shivajee V. Nallamothu. “Bennett Fracture.” National Library of Medicine, www.ncbi.nlm.nih.gov/books/NBK500035/. Accessed 21 June 2023.
LaStayo, Paul C., et al. “Fracture Healing: Bone Healing, Fracture Management, and Current Concepts Related to the Hand.” Science Direct, 14 June 2010, www-sciencedirect-com.uaf.idm.oclc.org/science/article/pii/S0894113003800030?via%3Dihub.
“What Are The Most Popular Fields of Medicine? .” Trinity School of Medicine, 22 May 2023, trinityschoolofmedicine.org/blog/5-most-popular-fields-of-medicine-in-2020/#:~:text=1.,Internal%20Medicine%20%26%20Primary%20Care.
This project is extremely well planned and organized. The fracture, known as Bennett’s fracture, is not the only one the author talks about, even though it’s one they are familiar with because of their break at age thirteen. Which is the fracture of the palmar-ulnar first metacarpal base, which was surrounded by the other metacarpals. The author also discusses a variety of other fractures that an individual could sustain as well and how those fractures would occur, like the comminuted or epiphyseal fracture. The objective I see is one that we discussed in the skeleton unit since it relates to understanding the stages of bone restoration because it is how bones mend after being damaged. Fractures are the cause of the damage in this case. The steps on top of how a current fracture heals are well-listed, and I see them in the right order. In addition, it is both easy to read and educational at the same time. I think it would be a simple concept that belonged to someone just learning about bones. There are very well-done illustrations of the body’s way of fixing a bone fracture, in addition to the many fractures addressed in the article. The illustrations look like a lot of time and energy went into them, but not only that, you can most definitely see what is going on, so they are very useful.
I would like to ament one portion ” I think it would be a simple concept that belonged to someone just learning about bones”. I reread this and what I trying to say is this steam project would help someone else just wanting to learn more about bones. To get usefully information about fracture healing. And be able to understand it .
Not that the way the Author said it was from someone with a simple understand. I realized my mistake.