Abstract
Bone healing is a unique and complex reparative process that results in fractures healing without scar tissue formation. Multiple factors have been implicated in altering this process. This paper reviews the factors that influence the process of bone healing and predispose to non-union development. Cognisance of these factors will assist orthopaedic surgeons in identifying fractures at risk of altered healing and guide the development of comprehensive management strategies for established non-unions.
Highlights
The human body has evolved the ability to spontaneously heal skeletal injuries through secondary bone healing and callus formation
In this review we explore the factors that influence normal bone healing and predispose to non-union development after a tibial shaft fracture
Bone healing is a complex cascade of events that results in the repair of fractures without the formation of scar tissue and can be classified into two histological types, namely primary and secondary bone healing.[12,13]
Summary
The human body has evolved the ability to spontaneously heal skeletal injuries through secondary bone healing and callus formation This is evident from healed fractures observed in Homo neaderthalensis and Homo erectus fossils.[1,2] This healing process is unique in nature as most tissues heal with scar tissue formation, while skeletal tissue repairs with bone that is histologically indistinguishable from the original bone. Manipulating this natural healing process in order to ensure proper alignment, maintenance of limb length and faster return to function, has been the goal of physicians throughout the ages. In this review we explore the factors that influence normal bone healing and predispose to non-union development after a tibial shaft fracture
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