Distal radial fractures heal by direct woven bone formation

Figures & data

Table

Patient	Day	Bleeding	Soft tissue	Old	Old	Bone	Free, woven	Cartilage
				necrosis	trabeculae	surviving	formation on	bone
						osteocytes	trab. surface
11	5	3	1	1	0	0	0	0
8	7	1	0	1	1	0	0	0
4	8	2	0	1	1	(1) ^a	0	0
1	9	1	0	1	0	0	1	0
5	10	2	1	1	1	0	0	0
7	12	0	1	1	0	0	1	0
10	12	0	1	1	0	0	0	1
2	13	0	0	1	0	(1) ^a	3	0
3	13	1	1	1	0	0	0	0
6	14	0	0	1	0	0	3	1
9	16	0	0	1	1	1	3	0
12	28	0	0	0	0	0	3	1

0 = none; 1 = some; 2 = moderate; 3 = predominating.

^a Parentheses indicate a few cells found during a second review of the slides.

Figure 1. Membraneous bone formation at an early stage, between old necrotic trabeculae (T), 13 days after injury.

Figure 2. Formation of woven bone in the marrow cavity between 2 old trabeculae (T), in which superficial osteocytes have survived. Specimen from 16 days after injury.

Figure 3. Woven bone in the marrow connecting to old trabeculae (T). Formation is still continuing at the lower right-hand corner (F). The same patient as in Figure 2.

Figure 4. The most prominent occurrence of cartilage (C) in the study. It is located between woven bone and a necrotic hematoma. There appears to be a gradual transition from woven bone, via fibrocartilage, to hyaline cartilage.

Figure 5. Woven bone formation among old trabeculae (T) in the proximal tibia of a mouse, 1 week after drilling a hole through the marrow. Bone formation appears to occur in the marrow compartment and to connect to old trabeculae, as for the human biopsies.