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Bone Graft: How does the broken bone assimilate the graft?
After fractures and bone grafts heal the tissue between the
fracture fragments is "woven bone" or "hard callus". Bone spicules
have been laid down at random and the tissue may be bulkier but is not as mechanically
sound as normal bone. The process of remodelling turns this tissue into "normal"
bone, that is a cylinder with compact bone round the circumference and spongy bone or a
cavity in the middle. In some way, likely related to piezo-electric current generation,
bone that is stressed is stimulated to grow denser and stronger. Unstressed bone is
absorbed. So there is a gradual process of thickening the parts of the callus which are
taking the weight and thinning of the parts which aren't. Over many months this transforms
the injury site back into something which is close to the original state.
Myles Clough MD OS Jan 3 2002
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