Answer:
d. hematoma formation, soft callus formation, bony callus formation, and bone remodeling
Explanation:
All body tissues have the ability to regenerate against injury, replacing damaged tissues with new tissues that must have the same shape and characteristics of healthy tissue. Bone is a tissue that despite its hardness has an important regeneration capacity and a certain time for repair. The bone repair process after a fracture is also called bone consolidation. In this text the different bone repair processes will be described when a fracture occurs and what happens when this process is delayed.
Bone consolidation occurs in 4 phases that follow one another. These are: inflammatory, proliferative, fracture callus formation and remodeling.
<u>Inflammatory and proliferative phase
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When a bone suffers an impact, it absorbs the energy released along with the surrounding soft tissues. If the amount of energy does not exceed the absorption capacity of bone forces nothing happens, but if this energy is excessive it will not be absorbed and the fracture will occur; which implies a local hemorrhage and necrosis of both bone and soft tissue cells, which surround the fracture area.
<u>Fracture callus formation
</u>
Between the second and third week the soft fracture callus begins to form. During this phase the cells proliferate in the periosteum (outermost layer of bone), in soft tissues and in all surrounding vascularized tissue; and they begin to differentiate into osteoblasts (cells that will form the new bone tissue), osteoclasts (cells that reabsorb and reshape the bone) and chondroblasts (cells that create cartilage tissues).
Periosteum cells proliferate rapidly, seeking the union of fracture fragments. Therefore, a periodic sleeve is formed that wraps around the soft callus. At this time the fracture can be manipulated without noticing crepitus, since the bone fragments do not move.
<u>Remodeling phase
</u>
The consolidation process ends with an adaptive remodeling, which can last for months or even years.
Various factors are involved in this consolidation process: cellular, vascularization, organism's biochemicals (hormones, vitamins), local biochemical factors (growth factors) and biophysical (mechanical) factors
