Breaking a bone, also known as a fracture, can occur to any one at any time. Being able to mend it successfully can be helped by providing the right nutrition. Elderly people or those with impaired circulatory disorders may be especially vulnerable to healing.
A bone fracture can occur when a significant force has been applied to the bone, as can happen in a fall. In some people, such as those with osteoporosis, those with bone damaged by cancer or bone infection, fractures can occur much more easily with only minor or minimal force. These are known as fragility or insufficiency fractures.
A stress fracture can occur when a repetitive force has been applied to bone. Running for example when a force is repeatedly applied. Microtraumas will often repair on their own when the cause is discontinued and the injured site is allowed to rest otherwise the injury can spread.
Trauma and injury can also occur to the soft tissue, ligaments and tendons around the fracture site.
The natural process of healing
The healing process of fractured bone takes around 5 weeks and begins with blood clotting at the site of break. The body then begins to mend the fracture with a combination of fibrous tissue and cartilage. During this time the fracture needs to be immobilised to allow for correct alignment. Immobilisation, such as a cast or metal rod, helps enable healing by keeping the fracture aligned, reducing pain and preventing further injury.
Complications of fracture healing include infection, connecting bones moving out of alignment, and poor immobilisation. Age can also influence how well a bone heals – elderly people can heal poorly or take longer due to the effect age has on cellular and molecular processes needed for healing.
The time it takes to heal a bone depends on a number of factors. Age and any health disorders can influence the healing process. Diabetics, people with peripheral vascular disease or poor circulation might take longer for healing to occur.
Healing of fractures
The healing of fractures is complex and involves growth factors, inflammatory cytokines, antioxidants, cells to break down damaged bone and cells to build new bone, hormones, amino acids and many nutrients. This healing occurs in three overlapping stages:
Inflammatory stage starts soon as a fracture occurs - the body starts to repair. It seals the wound with a blood clot and inflammatory cells begin the clean-up job. Osteoclast dissolve or recycle damaged bone debris. A cytokine cascade brings in the cells responsible for repair which differentiate into specialized cells to build new cartilage (chondroblast) and bone(osteoblasts). This process takes a few months.
Reparative is the second stage and begins about two weeks after the fracture has occurred. New soft bone (soft callus) is formed from proteins produced by the osteoblasts and chondroblast which will eventually harden as they integrate over a 6 -12 week time period.
Remodelling is the final stage. Callus matures and woven bone remodels into stronger bone (lamellar bone).
Helping fractures heal
Nutrition and supplements
Mending broken bones takes time and there are some nutrients which can help the process. A heathy diet - with plenty of micro and macro nutrients is essential to enhance the process of bone healing.
Protein
Protein is needed to supply amino acids. Protein can be found in foods such as eggs, meat, chicken, fish, and nuts/seeds/grains/legumes, or easily consumed in the form of protein shakes. Adequate protein is required for the repair process of rebuilding and immune health - amongst many other things.
Calcium
Calcium is needed by the body to replace bone loss. Calcium is the main component of bone and adequate amounts are necessary to replenish losses. Food sources include milk and dairy-based products, leafy green vegetables, almonds, legumes and seafood. Calcium hydroxyapatite, calcium citrate and calcium from algae are good forms for supplementation.
Vitamin D
To achieve the best absorption of calcium, Vitamin D is needed. Vitamin D3 (cholecalciferol) is synthesized in the skin but adequate amounts may be reduced during winter months or in older people. Vitamin D is available as a supplement and is often combined with calcium or available from cod liver oil, egg yolk, salmon, herring and tuna.
Vitamin K
Vitamin K works synergistically with vitamin D on bone density. Low levels are associated with reduced bone density and increased risk of fractures.
Multi minerals
Bone is not only made of calcium but many other minerals (magnesium, phosphorus, silicon and zinc for example). Supplementing with a multi mineral can help provide for these nutrients. Some calcium supplements include good amounts of important minerals.
- Zinc is a co-factor of many metalloproteins involved in the development of bone
- Manganese – is a co-factor for many enzymes involved in bone metabolism
- Magnesium improves the quality of bone
- Copper deficiency is associated with disorders of bone and cartilage and is important in the action of several enzymes involved in collagen and elastin production
Vitamin C
Vitamin C is associated with increased bone density. Vitamin C is particularly beneficial for help in healing fractures as it increases collagen production enhancing healing of soft tissue, ligaments, tendons and bone after a fracture.
- Collagen is the protein which forms the scaffolding of bone in which calcium and other minerals are deposited. It is essential to have healthy collagen for the construction of bone to take place. Along with vitamin C, the amino acids – lysine and proline are needed.
- Vitamin C plays an important role in supporting the immune function and offering protection from infection.
Reducing inflammation
In the beginning an inflammatory response to an injury occurring to the body is the start of repair and an important component of the healing process. Inflammation and damaged tissue create an abundance of free radicals which can over-load the natural antioxidant defence mechanisms. Supplemental antioxidant can help reduce free-radical damage and aid bone fracture healing. Antioxidants include: Vitamin E, vitamin C and alpha lipoic acid.
Support natural anti-inflammatory processors with vitamin C, bioflavonoids, quercetin, turmeric and omega 3 fatty acids.
References
Cellular Biology of Fracture Healing https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6542569/
- https://www.msdmanuals.com/en-au/professional/injuries-poisoning/fractures/overview-of-fractures?query=broken%20bones
- Hydroxyapatite–-Past, Present, and Future in Bone Regeneration https://journals.sagepub.com/doi/full/10.4137/BTRI.S36138
- Effects of Aging on Fracture Healing https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6517062/
- Nutritional Aspects of Bone Health and Fracture Healing https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5804294/
- Vitamin K and bone health https://pubmed.ncbi.nlm.nih.gov/11684396/
- Vitamin C—Sources, Physiological Role, Kinetics, Deficiency, Use, Toxicity, and Determination https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7918462/
- https://www.hsph.harvard.edu/nutritionsource/calcium/
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