Fracture non-union: Can biomarkers predict outcome?
Delayed bone healing and non-union occurs in approximately 10-15% of long bone fractures. Both pathologies may result in prolonged period of pain, disability and repetitive operative interventions. Despite intense investigations and progress done in understanding the pathophysiologic processes governing bone healing, the diagnostic tools have not been altered. The clinical findings and radiographic features remain the two important landmarks of diagnosing non-union and even when the diagnosis is established there is debate on the ideal timing and mode of intervention. Emerging evidence suggest that there are certain molecules and genes that can serve as predictors of potentially unsuccessful fracture union. This article summarises the current evidence on the available 'bio-markers'to predict fracture non-union.
Academic Department of Trauma and Orthopaedic Surgery, School of Medicine, University of Leeds, UK; Leeds Biomedical Research Unit, Leeds, UK.
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Pountos
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Georgouli
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Pneumaticos
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PV
Giannoudis
D000818:Animals; D015415:Biomarkers / Q000032:analysis; D019485:Bone Morphogenetic Proteins / Q000235:genetics*; D017102:Fracture Healing / Q000502:physiology*; D005599:Fractures, Ununited / Q000235:genetics*; D006801:Humans; D053773:Transforming Growth Factor beta1 / Q000097:blood
D015415:Biomarkers; D019485:Bone Morphogenetic Proteins; D053773:Transforming Growth Factor beta1
Biomarkers; Bone healing; Genetic factors; Non-union