Postfracture Vascular Changes and Healing Process

Introduction  Recent investigations have documented the sequence of vascular changes in the postfracture period. Fracture of a long bone leads to acute vasodilation throughout the traumatized limb.⁶ Acute vasodilation is followed by chronic enlargement of the potential vascular space of the limb. With the passage of time, the enlarged vascular space gradually shrinks to prefracture size.^5,7,8While the relationship of these vascular changes to the healing process is unknown, two chief possibilities come to mind. Vascular alterations may be accompanied by metabolic adjustments that may or may not be essential to the fracture healing process. Second, vascular changes, or more specifically, the gradual return of the enlarged vascular bed to prefracture levels, may be related to the consolidation of bony union at the fracture site.It is this latter possibility, a possible relationship of vascular bed recession to bony union, that is the concern of this investigation. The