Following fracture the bone undergoes repair and resolution. The pattern of changes seen on X-rays can indicate the approximate time that the fracture occurred. This can be important in assessment of possible physical abuse in children.
Stages:
(1) resolution of soft tissue injury
(2) periosteal new bone formation
(3) loss of fracture line resolution
(4) soft callus formation
(5) hard callus formation
(6) bone remodeling
|
Time Sequence |
Early |
Peak |
Late |
|
resolution of soft tissue injury |
2 - 5 days |
4 - 10 days |
10 -21 days |
|
periosteal new bone formation |
4 - 10 days |
10 - 14 days |
14 - 21 days |
|
loss of fracture line definition |
10 - 14 days |
14 -21 days |
|
|
soft callus |
10 - 14 days |
14 -21 days |
|
|
hard callus |
14 -21 days |
21 - 42 days |
42 - 90 days |
|
remodeling |
3 months |
1 year |
2 years to epiphyseal closure |
Time of Fracture Based on Pattern of Findings
|
resolution of soft tissue injury |
N |
Y |
Y |
Y or N |
Y or N |
N |
N |
|
periosteal new bone formation |
N |
N |
Y |
Y |
Y or N |
N |
N |
|
loss of fracture line definition |
N |
N |
N |
Y |
Y |
N |
N |
|
soft callus |
N |
N |
N |
Y |
Y |
N |
N |
|
hard callus |
N |
N |
N |
N |
Y |
Y |
N |
|
remodeling |
N |
N |
N |
N |
N |
N |
Y |
|
number of days after fracture |
< 2 |
2 - 4 |
4 - 10 |
10 - 14 |
14 - 21 |
21 - 90 |
> 90 |
Specialty: Clinical Laboratory, Emergency Medicine, Pedatrics
ICD-10: ,
