The Journal of Bone and Joint Surgery, Vol 73, Issue 6 832-847, Copyright © 1991 by Journal of Bone and Joint Surgery, Inc
Early histological and ultrastructural changes in medullary fracture callus
CT Brighton and RM Hunt
Department of Orthopaedic Surgery, University of Pennsylvania School of Medicine, Philadelphia 19104-6081.
Light and electron microscopic studies of early changes in the medullary
callus of a fracture of the rib in rabbits revealed the loss of normal
architecture of the marrow and the disappearance of blood vessels in the
region of high cellular density adjacent to the fibrin clot; the
enlargement and transformation of capillary and venous endothelial cells in
the region of low cellular density adjacent to the normal, uninjured
marrow; the appearance of polymorphic mesenchymal cells throughout the
medullary callus; and the appearance of osteoblasts and new-bone formation
by twenty-four hours after the fracture. The meaning of these morphological
changes is not clear. However, the spatial relationship between the various
cells suggests the possibility that the transformed endothelial cells,
reticular cells, and polymorphic mesenchymal cells may be interrelated and
may either be osteoblast progenitor cells or may in some way lead to the
appearance of osteoblasts in the early callus.