title: Current medical treatment strategies concerning fracture healing.
abstract: The morbidity and socioeconomic costs associated with bone healing are considerable. A number of fractures are complicated by impaired healing. This is prevalent in certain risk groups such as elderly, osteoporotics, post-menopausal women, and in people with malnutrition. The biologic process of fracture healing is complex and impacted by multiple factors. Some of them, such as the nutritional and health conditions, are patient-dependent, while others depend on the trauma experienced and stability of the fracture. Fracture healing disorders negatively affect the patient's quality of life and result in high health-care costs, as a second surgery is required to stabilize the fracture and stimulate bone biology. Future biotechnologies that accelerate fracture healing may be useful tools, which might also prevent the onset of these disorders. We list the characteristics of the drugs used for osteoporosis, but we point out in particular the use of strontium ranelate and teriparatide in our clinical practice in elderly patients, especially females, who reported fractures with risk of nonunion. This medical treatment could impaired fracture healing however, most of the evidence is obtained in animal studies and very few studies have been done in humans. Thus one could hypothesize the possibility of a medical treatment both as a preventive and as support to the synthesis. However, no clinical studies are available so far, and such studies are warranted before any conclusions can be drawn. A positive effect of osteoporosis treatments on bone healing is an interesting possibility and merits further clinical research.
authors.affiliation: Orthopaedic Clinic, University of Pisa, Pisa, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Giannotti
authors.forename: Vanna
authors.initials: V
authors.lastname: Bottai
authors.forename: Giacomo
authors.initials: G
authors.lastname: Dell'osso
authors.forename: Erica
authors.initials: E
authors.lastname: Pini
authors.forename: Gaia
authors.initials: G
authors.lastname: De Paola
authors.forename: Giulia
authors.initials: G
authors.lastname: Bugelli
authors.forename: Giulio
authors.initials: G
authors.lastname: Guido
keywords: fracture healing; strontium ranelate; teriparatide