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2014 ; 45 Suppl 2
(0 2
): S8-S15
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Biological perspectives of delayed fracture healing
#MMPMID24857030
Hankenson KD
; Zimmerman G
; Marcucio R
Injury
2014[Jun]; 45 Suppl 2
(0 2
): S8-S15
PMID24857030
show ga
Fracture healing is a complex biological process that requires interaction among
a series of different cell types. Maintaining the appropriate temporal
progression and spatial pattern is essential to achieve robust healing. We can
temporally assess the biological phases via gene expression, protein analysis,
histologically, or non-invasively using biomarkers as well as imaging techniques.
However, determining what leads to normal versus abnormal healing is more
challenging. Since the ultimate outcome of fracture healing is to restore the
original functions of bone, assessment of fracture healing should include not
only monitoring the restoration of structure and mechanical function, but also an
evaluation of the restoration of normal bone biology. Currently few non-invasive
measures of biological factors of healing exist; however, recent studies that
have correlated non-invasive measures with fracture healing outcome in humans
have shown that serum TGFbeta1 levels appear to be an indicator of healing versus
non-healing. In the future, developing additional measures to assess biological
healing will improve the reliability and permit us to assess stages of fracture
healing. Additionally, new functional imaging technologies could prove useful for
better understanding both normal fracture healing and predicting dysfunctional
healing in human patients.