As the chair and a professor of the Department of Orthopaedic Surgery at the Medical University of Ohio, Dr. Nabil Ebraheim teaches the diagnosis and operative treatment of diseases and injuries of the musculoskeletal system. Also the director of the university’s orthopaedic trauma fellowship and the author of many peer-reviewed papers, Dr. Nabil Ebraheim pursues a focus on bone healing.
Bone healing is a multiphase process. It begins with inflammation, which occurs when blood flows from the fracture into the surrounding area. As this happens, the tissue swells and the blood forms clots, which create stability at the site. This clotted blood also forms the initial scaffolding for the growth of new bone.
Bone production occurs first with the production of a soft callus. Specialized cells called chondroblasts create this initial repair structure, the building of which can take up to three weeks. Once the soft callus is fully formed, the body activates osteoblast cells to create new bone cells, which form a harder callus.
The final and longest phase of healing is known as bone remodeling. During this phase, which can take a period of three to nine years to complete, the new bone becomes harder and more structurally sound. At the same time, osteoclast cells dissolve the excess bone tissue at the outside of the hard callus, and the bone slowly returns to its original shape.