Biological and molecular profile of fracture non‐union tissue: current insights

Abstract

Delayed bone healing and non-union occur in approximately 10% of long bone fractures. Despite intense investigations and progress in understanding the processes governing bone healing, the specific pathophysiological characteristics of the local microenvironment leading to non-union remain obscure. The clinical findings and radiographic features remain the two important landmarks of diagnosing non-unions and even when the diagnosis is established there is debate on the ideal timing and mode of intervention. In an attempt to understand better the pathophysiological processes involved in the development of fracture non-union, a number of studies have endeavoured to investigate the biological profile of tissue obtained from the non-union site and analyse any differences or similarities of tissue obtained from different types of non-unions. In the herein study, we present the existing evidence of the biological and molecular profile of fracture non-union tissue.

Protective effect of berberine against oxidative stress-induced apoptosis in rat bone marrow-derived mesenchymal stem cells

“…Treatment of delayed healing, nonunion or a persistent bone defect represents a major challenge for traumatology department (31). Owing to the low immunogenicity and transplantability (32), BMSCs are an effective resource for transplantation in clinical application, with the establishment of cell banks for bone regenerative medicine (2,33).…”

Raman spectroscopy and coherent anti-Stokes Raman scattering imaging: prospective tools for monitoring skeletal cells and skeletal regeneration

“…Fractures alone cost the European economy E17 billion and the US economy $20 billion annually [1]. In the USA, there are around 8 million bone fractures per year, of which approximately 5-10% are associated with delayed healing or non-union [2]. Each year in the UK there are approximately 150 000 wrist, vertebral and hip fractures due to osteoporosis, with an estimated healthcare cost of £2.1 billion per annum.…”

Is there a role of coral bone substitutes in bone repair?

“…2,3 However, its use has several drawbacks including limited availability, variable graft quality, increased operative time and donor site morbidity. 4 To overcome the increasing need for bone graft materials, research has focused on the development of novel bone graft substitutes. 5,6 A large number of substitutes have been developed and a significant number are commercially available for clinical use.…”