Delayed fracture healing and nonunion occurs in up to 5-10% of all fractures, and can present a challenging clinical scenario for the treating physician. Methods for the enhancement of skeletal repair may benefit patients that are at risk of, or have experienced, delayed healing or nonunion. These methods can be categorized into either physical stimulation therapies or biological therapies. Physical stimulation therapies include electrical stimulation, low-intensity pulsed ultrasonography, or extracorporeal shock wave therapy. Biological therapies can be further classified into local or systemic therapy based on the method of delivery. Local methods include autologous bone marrow, autologous bone graft, fibroblast growth factor-2, platelet-rich plasma, platelet-derived growth factor, and bone morphogenetic proteins. Systemic therapies include parathyroid hormone and bisphosphonates. This article reviews the current applications and supporting evidence for the use of these therapies in the enhancement of fracture healing.
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http://dx.doi.org/10.11138/ccmbm/2016.13.2.101 | DOI Listing |
The concept of Debridement, Antibiotics and Implant Retention (DAIR) is well known in periprosthetic joint infections. Extrapolating this concept to fracture related infections is mired in controversies. Characteristics of the metal implant, duration of infection, state of fracture healing, microbiological profile etc.
View Article and Find Full Text PDFDelayed fracture healing (DFH), a common complication of post-fracture surgery, exhibits an incompletely understood pathogenesis. The present study endeavors to investigate the roles and underlying mechanisms of miR-656-3p and Bone Morphogenetic Protein-2 (BMP-2) in DFH. It was recruited 94 patients with normal fracture healing (NFH) and 88 patients with DFH of the femoral neck.
View Article and Find Full Text PDFJ Orthop Translat
January 2025
Musculoskeletal Research Laboratory of Department of Orthopaedics & Traumatology and Innovative Orthopaedic Biomaterial & Drug Translational Research Laboratory, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China.
The orthopaedic community frequently encounters polytrauma individuals with concomitant traumatic brain injury (TBI) and their fractures demonstrate accelerated fracture union, but the mechanisms remain far from clear. Animal and clinical studies demonstrate robust callus formation at the early healing process and expedited radiographical union. In humans, robust callus formation in TBI occurs independently of fracture fixation methods across multiple fracture sites.
View Article and Find Full Text PDFWorld J Clin Cases
January 2025
Stomatological Hospital and College, Anhui Medical University, Hefei 230032, Anhui Province, China.
Background: Complicated crown-root fracture (CRF) involves severe injury to the crown, root, and pulp, and may be accompanied by multiple root fractures. The loss of a tooth has lifelong consequences for children and teenagers, but the maintenance of pulp health and the calcific healing of multiple root fractures are rarely reported in the literature.
Case Summary: This case reports healing of a permanent tooth with complicated crown-root and additional root fractures, in which pulp health was maintained.
ACS Omega
January 2025
Shaanxi University of Chinese Medicine, Xianyang 712046, China.
Research on bone substitutes for repairing bone defects has drawn increasing attention, and the efficacy of three-dimensional (3D) printed bioactive porous scaffolds for bone defect repair has been well documented. Our previous studies have shown that psoralen can promote osteogenesis by activating the Wnt/β-catenin and BMP/Smad signaling pathways and their crosstalk effects, and psoralen nanospheres have a good osteogenesis-promoting effect with low cytotoxicity. The Chinese medicine oyster shell powder, characterized by its porous structure, strong adsorption, and unique bioactivity, has potential in fracture-promoting repair materials.
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