How Do Broken Bones Heal and How Long Does it Take?
Broken bones, also known as fractures, are a very common injury sustained after a car accident. The healing time of a fracture can vary greatly based on the severity and associated factors, but there are some common guidelines that can help you determine how long it will take to heal. In this post, I will discuss bone anatomy, the common time frame for fracture healing, as well as factors that can either speed up or slow down the process.
Bone Anatomy
There are several ways to look at bone anatomy. I will start with a zoomed-out view and then move in to the cellular level.
First, let’s examine what can be seen with the naked eye. Imagine you cut your thigh bone in half and then took the bone and looked into it. What you would see is a hollow interior surrounded by a dense exterior. The hollow portion is where your bone marrow is stored and the exterior is what you typically think of as bone. Since the exterior is the part that we primarily care about when you break a bone, let’s zoom in on this portion and look at it at the cellular level.
At the cellular level, bone is primarily composed of cartilage cells that have ossified (turned into bone) early in life. Mixed in with these ossified cells are several different specialized cells that resorb old bone or lay down new bone, as well as blood vessels that supply these cells with energy to do their jobs.
Fracture Healing Process
There are four stages that all broken bones go through to heal.
1. Hematoma formation (days 0 to 5 post-injury): when a bone is fractured, some of the blood vessels in the location of the broken bone are ruptured, which leaks blood into the area surrounding the fracture. Surprisingly, this is the desired response, because the blood pools together and forms a hematoma, which creates the base for the rest of the healing process.
2. Soft callus formation (days 5-11 post-injury): as blood and nutrients are brought to the fracture site, a network of cartilage and fibrous tissue is laid down, which creates a framework that will soon be replaced with bone. This network is composed primarily of collagen.
3. Bony callus formation (days 11-28 post-injury): during this phase, the network laid down in the soft callus phase is resorbed and replaced with bone cells. This process gradually sweeps across the entire surface of the break until the entire soft callus is replaced with the hard callus.
4. Bone remodeling (beginning around day 18 and lasting for months to years): the bony callus that is initially laid down is not perfect. It can be thought of as a decent rough draft – it’s pretty good and can withstand most forces. This is why you’re typically not allowed to return to high-intensity activity until at least 6 weeks after the injury – we want to wait at least 2 weeks after the initial bony callus has been completed (if everything healed appropriately) to allow it to become even stronger and more like the surrounding bone that is unbroken. During this phase, the bony callus is slowly broken down and replaced with bone cells that are specific to their place within the bone.
Negative Recovery Factors
There are several factors that contribute to a bone healing slower than expected. Some of these are largely outside of your personal control, such as misalignment of the fracture, infection, and old age. However, there are some factors that you have more control over, which include obesity, anemia, diabetes, parathyroid disease, malnutrition, and smoking. As always, the more resilient your body is when you sustain an injury, the better that injury is likely to heal.
Positive Recovery Factors
There are several steps you can take to improve the speed of bone healing. The cheapest one is improving dietary intake and adding certain supplements. In particular, high levels of calcium, protein, and vitamins C and D have been linked to faster bone recovery times. There is also a lot of recent research into the use of bone stimulators, which deliver an electrical signal over the area of the fracture to stimulate the release of specific compounds to aid in healing. You will likely need a prescription from a doctor to receive one of these devices.
Summary
Following a basic fracture that does not involve poor healing, a bone has recovered the majority of its resilience within 6 weeks of the injury. Environmental factors play a large role in delayed fracture healing and are best addressed prior to breaking a bone. On the flip side, supplementation following a fracture may help speed the recovery process, and there are several new tools that may also help. Please talk with your healthcare provider to establish a plan for returning to your prior level of function, as re-injury of a broken bone often leads to a longer recovery the second time around.
Western Slope Rehab and Performance is Here to Help
If you are struggling with injuries or have recently been in a motor vehicle accident, we can help. We are a physical therapy company that provides home-based orthopedic services in the Grand Junction, CO, area, as well as telehealth appointments throughout Colorado. If you would like to schedule a free consultation, you can call us as 970-462-9177, or fill out our contact form here.
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A lot of the research for today’s article comes from this paper.