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2015 ; 11
(1
): 45-54
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Fracture healing: mechanisms and interventions
#MMPMID25266456
Einhorn TA
; Gerstenfeld LC
Nat Rev Rheumatol
2015[Jan]; 11
(1
): 45-54
PMID25266456
show ga
Fractures are the most common large-organ, traumatic injuries to humans. The
repair of bone fractures is a postnatal regenerative process that recapitulates
many of the ontological events of embryonic skeletal development. Although
fracture repair usually restores the damaged skeletal organ to its pre-injury
cellular composition, structure and biomechanical function, about 10% of
fractures will not heal normally. This article reviews the developmental
progression of fracture healing at the tissue, cellular and molecular levels.
Innate and adaptive immune processes are discussed as a component of the injury
response, as are environmental factors, such as the extent of injury to the bone
and surrounding tissue, fixation and the contribution of vascular tissues. We
also present strategies for fracture treatment that have been tested in animal
models and in clinical trials or case series. The biophysical and biological
basis of the molecular actions of various therapeutic approaches, including
recombinant human bone morphogenetic proteins and parathyroid hormone therapy,
are also discussed.
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