Why do bones heal? “Because they are broken” – Says Graham Apley.
The above answer has been imprinted in my mind, as one of the first few quotes I had come across as a postgraduate more than 25 years ago. Every time a patient asks me about his or her fracture and its healing characteristic, it comes to my mind and that is practically every day, with me being an orthopedic surgeon.
Little Role in the Scheme of Nature
As we get older and “wiser” we get the strength to admit what little role we get to play in the scheme of things by nature. Why do bones break? The commonest being an impact, which loads the bone to failure. Bones are relatively plasticky and can absorb small amounts of load. The second being a minimal impact, which by itself when applied once, will not lead to a fracture, but when applied multiple times, can lead to a small crack, which propagates, these are called stress fractures. The other reason being a sick bone or a diseased bone, which has become weak and is unable to withstand smaller impacts and fails.
We might have observed the commonest animal on the street: a stray dog, limping on three limbs when it is injured, over period of days, it slowly brings the injured limb into utilization. As the injury heals, the pain reduces and it starts to run on all fours. No one has treated it! So, the fractures heal because the bone is broken.
Why and what for do we intervene.
Many of the fractures heal in a plaster cast or a splint. The healing depends on the age of the patient, location of the break and the damage to the tissues at the time of injury. The cast allows us in some instances to give rest and let the fracture heal in an optimal position. In some scenarios, we operate, the reason being unlike animals we want to return to normal activity with full function, for which we need to restore form. The above-mentioned variables remain the same, over which we have no control. Therefore, the time taken to heal remains the same, in fact it may be prolonged further due to the interference of surgery, but it’s a tradeoff worth taking in our quest for return of normalcy.
Other than surgeon factors its factors which occur at the instant of injury, that lead to complications like delayed healing or not healing at all. In routine clinical scenarios, surgery can make things worse, but cannot make bones heal faster. Orthopedic surgeons have the privilege of assisting nature in its work, rather than being able to substitute it. When complications do occur, either of them could be responsible.
Prevention is better than Cure
How do we get our bones to be stronger and less susceptible to injury? Eat healthy, exercise regularly and avoid smoking. Eat everything in moderation, including fat, only thing being, watch what kind of fats we are ingesting. Covid has taught us to be at home and many of us have become Covid cooks, this is a healthy trend, eat at home and avoid processed foods. Many people tend to skip breakfast in a quest to lose weight, never do that, and drink plenty of water throughout the day, especially if you live in a hot climate or you exercise.
They say anything you do for 21 days becomes a habit, start your day with exercise, that way you are under control of your time; you have no excuse to skip. Pick an exercise which you enjoy, all of them are good for bone strength as well as joints. Weight bearing exercises are the best to improve bone strength and have benefits across multiple systems of the body for enhanced general health.
Avoid food with high sugars, and fizzy drinks. Smokers are known to have delayed healing of fractures. Every cigarette is detrimental to bone and general health. With all these small steps, we can not only reduce the veracity of accident and also can strengthen to bear the very impact more strongly.
Article is written by Dr. G Satish Reddy, MS,M.Ch(Ortho) U.K. ; Senior Consultant Orthopedic Surgeon, Joint Replacement Surgeon and Specialist in Sports Medicine, Aster Prime Hospital, Ameerpet, Hyderabad