A novel specialized staging system for cancellous fracture healing, distinct from traditional healing pattern of diaphysis corticalfracture?

Metaphysis cancellous bone fracture is one of the most common fracture types in clinical orthopedic practice. The specialized healing process of cancellous bone fracture has long been ignored by the academic society. Comparing with diaphyseal cortical bone healing, cancellous bone healing showed less bone tissue necrosis, barely any hematoma formation, limited inflammation events and no external callus formation. Based on our clinical practice and preliminary study, we hypothesize that the healing process of metaphysis cancellous fracture is a distinct process which could be concluded into five overlapping stages with distinguished histological features of each other. Different from the traditional theory defining diaphyseal cortical fracture, our novel staging theory is specialized in cancellous bone tissue fully considering its unique histological features. This novel staging system may help clinical orthopedists gain specialized understanding concerning cancellous healing process and aid in their clinical evaluation and treatment to metaphysis cancellous bone fracture.