1 00:00:01,920 --> 00:00:04,720 Speaker 1: Welcome to brain Stuff, a production of I Heart Radio. 2 00:00:06,240 --> 00:00:10,400 Speaker 1: Hey brain Stuff, Lauren Bogle bomb here. If you experience 3 00:00:10,480 --> 00:00:13,160 Speaker 1: engine trouble, you take your car to or mechanic. If 4 00:00:13,240 --> 00:00:16,079 Speaker 1: your pipes leak, you call a plumber. And if you 5 00:00:16,120 --> 00:00:19,000 Speaker 1: fracture a leg, the usual course of action is to 6 00:00:19,160 --> 00:00:23,400 Speaker 1: visit a doctor. But unlike other things that may break 7 00:00:23,440 --> 00:00:26,760 Speaker 1: in life, bones begin healing on their own before you 8 00:00:26,920 --> 00:00:31,160 Speaker 1: even set foot in a waiting room. Doctors often play 9 00:00:31,200 --> 00:00:35,160 Speaker 1: a vital, sometimes life saving roll in a bones healing process, 10 00:00:35,800 --> 00:00:40,720 Speaker 1: but these experts basically help the body heal itself. Doctors 11 00:00:40,720 --> 00:00:44,280 Speaker 1: provide optimal conditions for bone repair and healing to take place. 12 00:00:44,760 --> 00:00:48,120 Speaker 1: The rest is up to your cells. Sometimes broken bones 13 00:00:48,159 --> 00:00:50,760 Speaker 1: can heal so thoroughly within a few months that even 14 00:00:50,760 --> 00:00:55,639 Speaker 1: an X ray can't determine the original fracture line. So 15 00:00:55,840 --> 00:00:59,280 Speaker 1: how does this amazing biological process work? How can a 16 00:00:59,360 --> 00:01:03,000 Speaker 1: fractured live m grow back to its former strength. Let's 17 00:01:03,040 --> 00:01:05,319 Speaker 1: first take a closer look at just what bones are 18 00:01:05,319 --> 00:01:10,080 Speaker 1: made of and how alive they really are. It's easy 19 00:01:10,120 --> 00:01:13,319 Speaker 1: to think of your bones as solid, lifeless matter upon 20 00:01:13,360 --> 00:01:16,920 Speaker 1: which all of our living tissue just sits. But your 21 00:01:16,959 --> 00:01:19,160 Speaker 1: skeleton is as much a living part of your being 22 00:01:19,280 --> 00:01:22,920 Speaker 1: as your softer tissues and organs. The body stores minerals 23 00:01:22,920 --> 00:01:26,400 Speaker 1: in the hard compact bone itself, and inside the center 24 00:01:26,400 --> 00:01:28,600 Speaker 1: of the bone, the body produces red blood cells and 25 00:01:28,640 --> 00:01:31,480 Speaker 1: the red marrow, and stores fat and the yellow marrow. 26 00:01:32,959 --> 00:01:36,360 Speaker 1: It's important to remember that your bones are constantly changing. 27 00:01:36,880 --> 00:01:40,960 Speaker 1: Cells called osteoclasts break down old bone so that osteo 28 00:01:41,040 --> 00:01:44,560 Speaker 1: blasts can replace it with new bone tissue, a process 29 00:01:44,600 --> 00:01:49,080 Speaker 1: called bone remodeling. Another type of cell called the chondrablast 30 00:01:49,200 --> 00:01:53,080 Speaker 1: forms new cartilage. These are three of the primary cells 31 00:01:53,120 --> 00:01:56,600 Speaker 1: responsible for bone growth, and not just the bone growth 32 00:01:56,640 --> 00:02:01,560 Speaker 1: you experience early in life. This constant bone remodeling gradually 33 00:02:01,600 --> 00:02:04,440 Speaker 1: replaces old bone tissue with new tissue over the course 34 00:02:04,440 --> 00:02:09,040 Speaker 1: of months. But what happens when a bone breaks? Almost 35 00:02:09,040 --> 00:02:11,880 Speaker 1: immediately after the break, the body begins to try and 36 00:02:11,919 --> 00:02:15,400 Speaker 1: put itself back together again, and doctors often divide the 37 00:02:15,440 --> 00:02:21,359 Speaker 1: overall process into four phases. First, there's a fracture hematoma. 38 00:02:21,639 --> 00:02:24,560 Speaker 1: When a bone breaks, the fissure also severs the blood 39 00:02:24,600 --> 00:02:27,640 Speaker 1: vessels running down the length of the bone, and blood 40 00:02:27,760 --> 00:02:30,400 Speaker 1: leaks out of these veins and quickly forms a clot. 41 00:02:30,800 --> 00:02:35,200 Speaker 1: That's the fracture hematoma. This helps to stabilize the bone 42 00:02:35,240 --> 00:02:38,960 Speaker 1: and keep both pieces lined up for mending. The clot 43 00:02:39,040 --> 00:02:41,440 Speaker 1: also cuts off the flow of blood to the jagged 44 00:02:41,520 --> 00:02:45,960 Speaker 1: bone edges. Without fresh blood, these bone cells quickly die. 45 00:02:46,400 --> 00:02:49,560 Speaker 1: Swelling and inflammation follow due to the work of cells 46 00:02:49,600 --> 00:02:53,919 Speaker 1: removing dead and damaged tissue. Tiny blood vessels grow into 47 00:02:53,919 --> 00:02:59,320 Speaker 1: the fracture hematoma to fuel the healing process. After several days, 48 00:02:59,320 --> 00:03:02,919 Speaker 1: the fracture he toma develops tougher tissue, transforming it into 49 00:03:02,960 --> 00:03:07,440 Speaker 1: a soft callous. The cells, called fiber blasts begin producing 50 00:03:07,520 --> 00:03:10,800 Speaker 1: fibers of collagen, which is the tough protein that mostly 51 00:03:10,840 --> 00:03:15,040 Speaker 1: makes up bone and connective tissue. The condrablasts then begin 52 00:03:15,120 --> 00:03:18,600 Speaker 1: to produce a type of cartilage called fibro cartilage. This 53 00:03:18,760 --> 00:03:21,800 Speaker 1: forms up through the callous, transforming it again into a 54 00:03:21,840 --> 00:03:26,000 Speaker 1: tougher fibro cartilagenus callous, which bridges the gap between the 55 00:03:26,040 --> 00:03:29,720 Speaker 1: two pieces of bone. This callous generally lasts for about 56 00:03:29,760 --> 00:03:35,120 Speaker 1: three weeks. Next, osteoblasts move in and produce bone cells, 57 00:03:35,160 --> 00:03:39,280 Speaker 1: transforming the callous into a bone callous. This hard shell 58 00:03:39,440 --> 00:03:42,480 Speaker 1: lasts three to four months, and it provides the necessary 59 00:03:42,480 --> 00:03:45,520 Speaker 1: protection and stability for the bone to enter the final 60 00:03:45,560 --> 00:03:49,880 Speaker 1: stage of healing. At this point, the body establishes the 61 00:03:49,880 --> 00:03:53,040 Speaker 1: position of the bone within the flesh, begins reabsorbing bits 62 00:03:53,040 --> 00:03:56,320 Speaker 1: of dead bone, and has that hard callous to bridge 63 00:03:56,320 --> 00:04:00,080 Speaker 1: the gap between the two pieces of bone. However, this 64 00:04:00,320 --> 00:04:02,760 Speaker 1: bulge of tissue needs a lot of work before the 65 00:04:02,800 --> 00:04:08,160 Speaker 1: bone can take any strain. Osteoclasts and osteoblasts spend months 66 00:04:08,280 --> 00:04:12,720 Speaker 1: remodeling bone by replacing the bone callous with harder, compact bone. 67 00:04:13,520 --> 00:04:17,719 Speaker 1: These cells also decrease the callous buld, gradually returning the 68 00:04:17,720 --> 00:04:21,200 Speaker 1: bone to its original shape. The blood circulation within the 69 00:04:21,200 --> 00:04:25,159 Speaker 1: bone improves, and the resulting influx of bone strengthening nutrients 70 00:04:25,240 --> 00:04:30,120 Speaker 1: such as calcium and phosphorus strengthen the bone. However, even 71 00:04:30,200 --> 00:04:33,640 Speaker 1: in the best of cases, fractures often require medical attention 72 00:04:33,720 --> 00:04:38,279 Speaker 1: to heal as smoothly as possible. Of first, there's the diagnosis. 73 00:04:38,720 --> 00:04:41,880 Speaker 1: Before any further treatment can happen, the doctor must determine 74 00:04:41,920 --> 00:04:44,960 Speaker 1: whether a fracture occurred at all, and, if so, the 75 00:04:45,000 --> 00:04:49,040 Speaker 1: severity of the injury. Doctors generally accomplished this by examining 76 00:04:49,040 --> 00:04:51,800 Speaker 1: the patient and inspecting X rays or other images of 77 00:04:51,839 --> 00:04:55,720 Speaker 1: the damaged area. Then, once they figure out what needs 78 00:04:55,720 --> 00:04:59,240 Speaker 1: to be done. There's immobilization. This is how the doctor 79 00:04:59,279 --> 00:05:01,919 Speaker 1: helps your body line up the broken bone and limit 80 00:05:01,960 --> 00:05:05,760 Speaker 1: mobility so that the growing calluses aren't damaged. They can 81 00:05:05,800 --> 00:05:09,200 Speaker 1: help immobilize the affected area with a splint, cast brace, 82 00:05:09,320 --> 00:05:13,160 Speaker 1: or sling. A realigning broken bones can be painful, so 83 00:05:13,279 --> 00:05:15,799 Speaker 1: during this step a patient might need anything from local 84 00:05:15,839 --> 00:05:20,960 Speaker 1: anesthetic to spinal anesthesia to temporarily lessen the pain. In 85 00:05:21,040 --> 00:05:25,160 Speaker 1: the case of more complex fractures that require very specific immobilization, 86 00:05:25,440 --> 00:05:29,119 Speaker 1: the doctor may apply traction, which is a system of weights, ropes, 87 00:05:29,120 --> 00:05:33,360 Speaker 1: and pulleys that constantly pull on fractured limbs to maintain alignment. 88 00:05:35,200 --> 00:05:39,000 Speaker 1: Most fractures can be treated without surgery, but sometimes doctors 89 00:05:39,040 --> 00:05:42,960 Speaker 1: perform surgery to remove foreign materials or bone fragments, or 90 00:05:43,240 --> 00:05:46,039 Speaker 1: sometimes the best way to stabilize certain fractures is to 91 00:05:46,240 --> 00:05:49,719 Speaker 1: go in and align the bones with metal rods, implanted screws, 92 00:05:49,760 --> 00:05:52,920 Speaker 1: and pins. Some fractures, such as those to the hip 93 00:05:52,920 --> 00:05:59,680 Speaker 1: and joints, require artificial replacements. Finally, there's rehabilitation. The same 94 00:06:00,040 --> 00:06:03,479 Speaker 1: bullization that keeps stress off the healing bone also leaves 95 00:06:03,520 --> 00:06:06,880 Speaker 1: the surrounding muscles with little to do. This leads to 96 00:06:06,880 --> 00:06:10,560 Speaker 1: the loss of muscle mass, strength, and flexibility. The special 97 00:06:10,600 --> 00:06:15,159 Speaker 1: exercise regimes allow individuals to gradually rehabilitate their newly healed 98 00:06:15,200 --> 00:06:23,560 Speaker 1: limbs without risking re injury. Today's episode is based on 99 00:06:23,600 --> 00:06:26,119 Speaker 1: the article how do broken bones Heal? On how stuff 100 00:06:26,120 --> 00:06:29,120 Speaker 1: works dot com, written by Robert Lamb. Brain Stuff is 101 00:06:29,160 --> 00:06:31,280 Speaker 1: production of by Heart Radio in partnership with how stuff 102 00:06:31,320 --> 00:06:34,000 Speaker 1: works dot Com, and it's produced by Tyler Clang. The 103 00:06:34,080 --> 00:06:36,320 Speaker 1: four more podcasts from my heart Radio, visit the i 104 00:06:36,400 --> 00:06:39,160 Speaker 1: heart Radio app, Apple Podcasts, or wherever you listen to 105 00:06:39,240 --> 00:06:40,080 Speaker 1: your favorite shows.