BONES HEALING

(Kumar and Narayan, 2014)Abstract

The healing of a fracture is one of the most remarkable of all the repair processes in the body since it
results, not in a scar, but in the actual reconstitution of the injured tissue in something very like its
original form. It is not to be expected therefore that the mechanisms controlling such a process will be
easily elucidated and indeed they involve problems of cellular homeostasis which are among the most
fundamental in biology. If it is not quite the “cunning’st pattern of excelling nature” then it is something
quite close to it and a great deal of that pattern at present stands unrevealed. However, this review is
primarily concerned with those features which have direct clinical relevance and it is fortunately
possible to treat fractures successfully without a complete understanding of the cellular mechanisms
involved without at the same time relying entirely on empiricism. A number of factors influence the
healing which can be identified from both clinical and experimental work and may be taken into
consideration to put treatment on a more rational basis. It is with these observations that we shall be
particularly concerned and cellular mechanisms will be discussed only if they appear to have clinical
implications. Such an account must necessarily include details of the healing process as it is modified by
contemporary methods of treatment but first it is necessary to consider the events that occur in the
healing of a simple fracture in an unsplinted long bone.

(Einhorn and Gerstenfeld, 2015)Abstract

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.

(Oryan, Monazzah and Bigham-Sadegh, 2015)Abstract

Bones are organs of the skeletal system, providing shape, mechanical support, and protection to the
body and facilitating the movement. In addition, bones contribute to the mineral homeostasis of the
body and have recently been found to participate in endocrine regulation of energy metabolism[1-2].
The well-known limitations associated with clinical use of autografts and allografts continue to drive
efforts to develop bone graft substitutes, using the principles of biomaterials and tissue engineering[3].
Under some stressful and continuous compressive conditions, the ability of the bone tissue to tolerate
strength decreases. Whenever these forces overcome the toleration of the bone tissue, bone fracture
occurs[4]. The highly complex process of fracture healing is still not fully understood; however, research
in the recent years have identified associations between various factors that affect the repair process
and healing outcome[5]. During skeletal growth or fracture healing, a temporary structure with a matrix
of irregularly arranged collagen fibers and randomly dispersed crystals known as woven bone precedes
the development of lamellar cortical bone. The osteocytes of the cancellous bone move into the
sinusoids in the marrow via the canaliculi as the cancellous bone does not contain Haversian systems[6].

(Affshana and Priya, 2015)Abstract

Aim:The aim of this review is to determine the healing mechanism of bones. Objective:To investigate
healing mechanism and to evaluate the associated risk factors. Background:Fracture is defined as a
break or discontinuity in the periosteum of bone. Trauma or injury to the bones of the human body is
increasing with the development of industry and transportation. Trauma is the biggest killer of human
beings all over the world. Fracture may be caused either by direct or indirect violence. Direct violence
may be caused at the site of impact. Indirect violence causes the force to be transmitted to bone away
from the site of impact and producing an impact there.Torsion produces simple or compound fracture.
Reduction of the fractured bone,immobilisation and provision of blood flow are important in the healing
of fractures. Reason:This review highlights the mechanisms of bone healing and the techniques used in
the treatment.

(Tarantino et al., 2011)Abstract

A correct fracture healing depends on the synergy between biomechanical, molecular and cellular
factors. Focusing on different stages, fracture hematoma represents the starting point of the
inflammatory process, with a critical role in triggering the process of fracture healing. The essential
factors for bone repair are the activation of mesenchymal stem cells and the release of growth and
regulatory factors. Moreover, the efficacy of fracture healing is determined by three ideal conditions:
adequate blood supply, good contact between bone fragments and good stability. It is remarkable how
the implant choice influences fracture healing after surgical treatment. In osteoporosis, bone quality
adversely affects the tissue structural competence, increasing the risk of a complicated fracture healing.
The qualitative and quantitative alterations established at the cellular level during osteoporosis explain
the progressive deterioration of bone tissue healing ability.
Daftar Pustaka
Affshana, M. and Priya, J. (2015) ‘Healing Mechanism in Bone Fracture .’, Journal of Pharmaceutical
Sciences and Research, 7(7), pp. 441–442.

Einhorn, T. A. and Gerstenfeld, L. C. (2015) ‘Fracture healing: Mechanisms and interventions’, Nature
Reviews Rheumatology. Nature Publishing Group, 11(1), pp. 45–54. doi: 10.1038/nrrheum.2014.164.

Kumar, G. and Narayan, B. (2014) ‘The biology of fracture healing in long bones’, Classic Papers in
Orthopaedics, pp. 531–533. doi: 10.1007/978-1-4471-5451-8_139.

Oryan, A., Monazzah, S. and Bigham-Sadegh, A. (2015) ‘Bone injury and fracture healing biology’,
Biomedical and Environmental Sciences, 28(1), pp. 57–71. doi: 10.3967/bes2015.006.

Tarantino, U. et al. (2011) ‘Bone healing and osteoporosis’, Aging Clinical and Experimental Research,
23(2 SUPPL.), pp. 62–64.