It's generally a 3-part process

[00:00:00] Host Amber Smith: Here's some expert advice from Dr. Rajin Shahriar from Upstate Medical University. How long do bone fractures take to heal in children?

[00:00:10] Rajin Shahriar, MD: Generally fractures have a three-part process by which they heal. And the first part of the healing process is actually the fracture itself creates bleeding and injury that the body knows to respond to. So what happens is that when the bone breaks, it bleeds, and the signals from that bleeding create an inflammatory response. And the body sends themselves and other tissue-healing properties to regenerate that area of damaged bone. And that process starts immediately after the fracture happens and continues for several weeks.

Then, there's a process by which the body will try to unite or bring those two pieces of bone back together. Oftentimes, the way that the body will do that is by actually forming cartilage first. And that cartilage basically increases the stiffness at the fracture site, and that callous eventually turns into bone through the body's healing process. But interestingly, you can't see a lot of that callous on the X-ray. So many times when we see families in clinic, we have to tell them about the way the fractures healed because oftentimes they're looking for the signs of healing very early on when it is probably healing, but we can't see it on X-ray.

So once the bone has joined back up together, we call that "union," basically the fracture having joined back together. But there's a third phase called remodeling, and that takes many months to years. The way that I like to talk about remodeling is comparing it to when you get a big cut on your skin. So the first thing that happens is that, just like with bone, it bleeds, but then it heals together, and it makes a scab. So that scab is what we call callous, or union for bone. And then remodeling is when that scab falls off, and then the skin is usually a little bit hyperpigmented or dark. And then it takes months for that color to fade away and go back to normal.

So that's what remodeling is in bone as well, where the bone will change shape, straighten out, do other things in order to go back to its final form. And that takes many months to years.

[00:02:32] Host Amber Smith: You've been listening to pediatric orthopedic surgeon Rajin Shahriar from Upstate Medical University.