The Life of a Fracture: Biologic Progression, Healing Gone Awry, and Evaluation of Union.

JBJS Rev · Aug 2020 · Review

Hellwinkel JE, Miclau T, Provencher MT, Bahney CS, Working ZM

Orthopaedic Trauma Institute, University of California, San Francisco (UCSF) and Zuckerberg San Francisco General…

Orthopaedic Trauma

SUMMARY — THE REDUCTIONReviews the molecular biology of fracture healing and modifiable risk factors, arguing current union-monitoring techniques are outdated and better objective assessment tools are needed.
Abstract, as published

New knowledge about the molecular biology of fracture-healing provides opportunities for intervention and reduction of risk for specific phases that are affected by disease and medications. Modifiable and nonmodifiable risk factors can prolong healing, and the informed clinician should optimize each patient to provide the best chance for union. Techniques to monitor progression of fracture-healing have not changed substantially over time; new objective modalities are needed.

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