The Healing Process
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FractureThe mandibular condyle is fractured.
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HaematomaBlood flows to the fracture site from injured blood vessels and pools, forming a hematoma. This induces the release of inflammatory cells and molecules.
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GranulationThe fracture site is then organised as granulation tissue is formed. This acidic environment triggers osteoclast activity which resorbs necrotic bone, and osteoblastic activity which deposits new bone to bridge the fracture ends. This is known as osteoid. During this stage, new small blood vessels are formed.
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Soft Callus A soft callus forms on the osteoid bridges which extends throughout the fracture gap connecting the ends of the bone. This is a fibrous woven bone and follow a process known as endochondral ossification which helps to stabilise the fracture site.
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Hard CallusThe callus hardens by 6-12 weeks after fracture in which it is replaced by new woven bone, forming a hard callus.
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RemodelingThe final stage of bone healing involves joining the fracture ends and re-organising the new bone into normal cortical bone structure. The end result resembles the pre-fracture state of bone.
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