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Review
. 2019 Jul;13(2):1-10.
doi: 10.5704/MOJ.1907.001.

Fracture Non-Union: A Review of Clinical Challenges and Future Research Needs

S K Stewart  1
Affiliations
Review

Fracture Non-Union: A Review of Clinical Challenges and Future Research Needs

S K Stewart. Malays Orthop J. 2019 Jul.

Abstract

Non-union of bone following fracture is an orthopaedic condition with a high morbidity and clinical burden. Despite its estimated global prevalence of nine million annually, the limit of bone regeneration therapy still results in patients living with pain, a reduced quality of life and associated psychological, social and financial repercussions. This review provides an overview of the current epidemiological and aetiological data, and highlights where the clinical challenges in treating non-union lie. Current treatment strategies are discussed as well as promising future research foci. Development in biotechnologies to treat non-union provides exciting scope for more effective treatment for this debilitating condition.

Keywords: biotechnologies; bone; bone healing; fracture; non-union.

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Figures

Fig. 1:
Fig. 1:
Health Status Utility Scores based on Time Trade Off (0 = death. 1 = perfect health). The dashed line separates the medical conditions associated with a utility score significantly better than femoral non-union (p<0.05). Adapted from Brinker et al.
Fig. 2:
Fig. 2:
The diamond concept of fracture healing describes the three biological prerequisites (stem cells, growth factors and osteoconductive scaffolds) and one mechanical prerequisite (optimal mechanical environment) required for bone healing to occur.
See this image and copyright information in PMC

References

    1. Crenshaw H. Delayed Union and Non-Union of Fractures. In: Crenshaw A, editor. Campbell’s Operative Orthopaedics. Vol. 3. CV Mosby; 1987. p. 118.
    1. Food and Drug Administration Guidance Document for Industry and CDRH Staff for the Preparation of Investigational Device Exemptions and Premarket Approval Applications for Bone Growth Stimulator Devices; Draft; Availability. United Stated: Office of the Federal Register, National Archives and Records Administration. 1998. p. 63. 23292-3 FR 23292.
    1. Matin P. Bone Scintigraphy in The Diagnosis and Management of Traumatic Injury. Semin Nucl Med. 1983;13(2):104–22. - PubMed
    1. Malik ZU, Mahmood K, Ahmed NT, Khan A, Tariq S, Hussain S. Analysis of Causes and Treatment Modality in Non-Union of Long Bones Diaphyseal Fractures. Pakistani Armed Forces Med. J. 2011;61(3):433–7.
    1. Frölke JPM, Patka P. Definition and Classification of Fracture Non-Unions. Injury. 2007;38:S19–22. - PubMed

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