Lane and Sandhu used a histologic score to evaluate the process of fracture union. While developed for experimental bone grafting in animals, the same score can be applied to human fracture repair. The authors are from the Hospital for Special Surgery in New York City.
Histologic parameters:
(1) union
(2) spongiosa
(3) cortex
|
Parameter |
Finding |
Point |
|
union |
no evidence of union |
0 |
|
|
fibrous union |
1 |
|
|
osteochondral union |
2 |
|
|
bone union |
3 |
|
|
complete reorganization of shaft |
4 |
|
spongiosa |
no osseous cellular activity |
0 |
|
|
early apposition of new bone |
1 |
|
|
active apposition of new bone |
2 |
|
|
reorganizing spongiosa; osteoclasts present |
3 |
|
|
completely reorganized spongiosa |
4 |
|
cortex |
none |
0 |
|
|
early appearance |
1 |
|
|
bone formation under way |
2 |
|
|
mostly reorganized |
3 |
|
|
completely formed |
4 |
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 12
• The higher the score the greater the degree of fracture healing.
Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general
