Chinese Journal of Tissue Engineering Research ›› 2019, Vol. 23 ›› Issue (20): 3188-3194.doi: 10.3969/j.issn.2095-4344.1156

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Fracture healing mechanism at molecular signaling pathway and cellular levels

Yang Nan1, Chen Yueping2, Zhang Xiaoyun2   

  1. 1Guangxi University of Chinese Medicine, Nanning 530001, Guangxi Zhuang Autonomous Region, China; 2Department of Traumatic Orthopedics and Hand Surgery, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning 530011, Guangxi Zhuang Autonomous Region, China
  • Online:2019-07-18 Published:2019-07-18
  • Contact: Chen Yueping, Doctoral supervisor, Chief physician, Department of Traumatic Orthopedics and Hand Surgery, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning 530011, Guangxi Zhuang Autonomous Region, China Zhang Xiaoyun, Master, Attending physician, Department of Traumatic Orthopedics and Hand Surgery, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning 530011, Guangxi Zhuang Autonomous Region, China
  • About author:Yang Nan, Master candidate, Guangxi University of Chinese Medicine, Nanning 530001, Guangxi Zhuang Autonomous Region, China
  • Supported by:

    the National Natural Science Foundation of China, No. 81760796 (to CYP)| the Natural Science Foundation of Guangxi Zhuang Autonomous Region, No. 2015GXNSFAA139136 (to CYP)| the Basic Ability Improvement Project of Young Teachers in Guangxi Universities, No. KY2016YB204 (to ZXY)| the Key Project of Health Department of Guangxi Zhuang Autonomous Region, No. S201419-05 (to CYP)

Abstract:

BACKGROUND: Nonunion and delayed union of fractures not only cause great troubles to individuals and families, but bring huge financial burden to the society. The optimal fracture treatment requires understanding of the complex physiological process of fracture healing.

OBJECTIVE: To explore and compare the fracture healing mechanism by reviewing the relevant literature, so as to provide new idea for clinical diagnosis and treatment.
METHODS: CNKI, WanFang, VIP and PubMed databases were retrieved with the keywords of “fracture healing, nonunion, inflammation, signaling pathways, osteoclasts, osteoblast, BMP, Wnt, Hedgehog, PTH” in Chinese and English, respectively. The articles concerning the molecular/signaling pathway/cell of fracture healing mechanism, the repetitive studies were excluded, and finally 46 eligible articles were enrolled for analysis.
RESULTS AND CONCLUSION: (1) By summarizing and discussing the mechanism of fracture healing from the aspects of inflammation stage, signal pathway and cell, we found that the contradiction between clinical and early scientific research (such as adverse reactions) can be unified in deep research. (2) However, the current research results cannot solve all clinical problems due to the complicated mechanisms of fracture healing. (3) The interaction between different molecules makes it difficult to find a clinically significant marker for the clinical diagnosis of early nonunion. (4) It is necessary to develop more sophisticated experimental equipment and design more rigorous scientific research programs to serve the clinical practice. (5) However, according to the current research results, we can consider cooperating with biomimetic delivery of signals for bone tissue engineering to make the original isolated, planar and static research results have three-dimensional dynamics more in line with the clinical treatment needs, which is the future direction.

Key words: fracture healing, inflammation phase, signaling pathway, osteoclasts, osteoblasts, bone morphologic protein, Wnt, Hedgehog, parathormone, the National Natural Science Foundation of China

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