Three to Five Days Following the Fracture
The Inflammation Stage begins the moment the bone is broken and lasts for around five days. As we have described earlier, bone has a very good blood supply due to the channels within its structure. When a fracture occurs there is massive disruption to these channels and a large amount of bleeding from the fracture fragments. This is what causes immediate swelling and bruising in the area of the broken bone. This is known as a Haematoma, which means bleeding within the tissue.
The damaged bone tissue at the edges of the fracture fragments die back and the dead cells release chemicals called Cytokines which initiate the healing process. Osteoclasts work to remove the dead bone cells. However, Osteoblasts are unable to work to lay down new bone tissue at this stage because of the movement of the fracture fragments which stops Osteoblast activity.
The principle of treatment by a trauma doctor during this immediate stage following a broken bone is to ensure the fracture fragments are returned back into place. This helps to stem the blood flow from the broken bones and substantially reduces the pain.
Within hours of the fracture, the blood from the fracture fragments forms a mesh of clotted blood, which is the first link between the two fragments. The mesh contains special cells called Fibroblasts, which begin to lay down tissue called Granulation tissue between 4 and 10 days after the fracture occurs. The Granulation tissue forms a ‘scaffold’ between the two fragments, from which the formation of a Soft Callus can begin.