Orthonotes
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Fracture Healing — Biology & Timelines

Phases: inflammation → soft callus (cartilage) → hard callus (woven bone) → remodeling (lamellar). Primary (direct) vs secondary (indirect) healing; absolute vs relative stability concepts. Cell sources: periosteum (key), endosteum, marrow, surrounding soft tissues. Mechanical environment (strain theory) dictates tissue type; too much motion → nonunion. Timelines vary by bone/age/blood supply—tibia slower than femur; smokers/NSAIDs may delay.