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Fracture Healing and Progress Towards Successful Repair

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Racing for the Surface

Abstract

Despite the intrinsic healing capacity of bone and advancements in orthopedic technologies, well-established interventions, including autologous bone grafting, have had a relatively limited impact on easing the burden of a proportion of the 5–20% of long bone fracture patients who suffer from delayed healing or nonunion. In this chapter, we describe how the biology of bone development and bone homeostasis are recapitulated in bone healing, and how immunological and mechanical factors regulate healing. We present the current barriers faced clinically, outlining some of the main risk factors associated with the development of delayed healing and nonunion, with a focus on bone infection, and how it hijacks the bone healing process, ultimately leading to bone destruction. We conclude by depicting the outlook on fracture healing, outlining the progress to-date and the biggest challenges we face, while highlighting how our increasing understanding of the immunomodulation of bone healing can potentially be harnessed to develop innovative strategies for patient benefit.

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Authors and Affiliations

  1. AO Research Institute Davos, Davos, Switzerland

    William A. Lackington & Keith Thompson

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  1. William A. Lackington
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  2. Keith Thompson
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Correspondence to William A. Lackington .

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  1. Department of Orthopaedics School of Medicine, West Virginia University, Morgantown, WV, USA

    Bingyun Li

  2. AO Research Institute Davos, Davos Platz, Graubünden, Switzerland

    Thomas Fintan Moriarty

  3. Department of Chemical Engineering, Northeastern University, Boston, MA, USA

    Thomas Webster

  4. Department of Mechanical Engineering, University of Manitoba, Winnipeg, MB, Canada

    Malcolm Xing

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Lackington, W.A., Thompson, K. (2020). Fracture Healing and Progress Towards Successful Repair. In: Li, B., Moriarty, T., Webster, T., Xing, M. (eds) Racing for the Surface. Springer, Cham. https://doi.org/10.1007/978-3-030-34471-9_10

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