the fracture is not tender to palpate or with movement. Hard callus is weaker than normal bone but is better able to withstand external forces and equates to the stage of "clinical union", i.e. Soft callus is plastic and can easily deform or bend if the fracture is not adequately supported. Soft callus is organised and remodelled into hard callus over several weeks. These cells lay down woven bone which stabilises the fracture site. Over the next few weeks, this primary callus is transformed into a bony callus by the activation of osteoprogenitor cells. Phase 2 - Reparative Phase (Days - Weeks) This is not readily visible on radiography. Phase 1 takes approximately a week, forming a primary callus which is non-mineralized. This forms a matrix for bone formation and primary callus. ![]() The fibroblasts, chondroblasts and the ingrowth of capillaries is then infiltrated by fibrovascular tissue. The inflammatory reaction results in the release of cytokines, growth factors and prostaglandins, all of which are important in healing. This prevents additional bleeding and provides structural and biochemical support for the influx of inflammatory cells. Immediately at the time of fracture, the space between the ends of the fracture is filled with blood, forming a haematoma. Phase 1 - Inflammatory Phase (Hours - Days) The pathophysiological sequence of events that occur following a fracture for bone healing can be divided into three main phases
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