A tibial shaft fracture is fixed with an anatomically reduced, compressed plate achieving absolute stability. Which pattern of healing is expected at the fracture site?

• A Endochondral ossification through a fibrocartilaginous callus
• B Direct osteonal (primary cortical) remodelling without visible callus ✓
• C Intramembranous ossification within a large haematoma
• D Replacement of the gap by dense fibrous tissue that persists as pseudoarthrosis

Explanation

Rigid internal fixation with interfragmentary compression produces strain below 2 percent and a gap under about 0.01 mm, permitting cutting cones to cross directly and Haversian remodelling to unite the cortex without callus formation. This is primary or direct bone healing. Secondary healing with callus occurs when micromotion exists, as with casts and intramedullary nails, so option A describes indirect healing, not what rigid compression achieves.

Reference: Rockwood and Green's Fractures in Adults, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.