Future modalities to assess fracture healing

Abstract

Objectives: Fracture healing remains a complex process routinely evaluated in clinical practice with sequential radiographs. Assessing the presence of union is a critical issue in patient care, with widespread implications in terms of overall decision-making and postoperative rehabilitation. Nonunion assessment, whether it be with radiographs or more advanced imaging, has far-reaching consequences for the patient in addition to the health care system. The purpose of this review was to explore new, emerging modalities for the assessment of fracture healing.

Methods: A review of the current, relevant literature regarding the use of serologic markers and radiostereometric analysis was conducted, and the results were summarized.

Results: Emerging techniques to assess fracture healing have been evaluated, including the use of serologic markers as well as radiostereometric analysis. Their potential applications extend beyond the simple assessment of a united fracture, with the capacity to predict nonunion at earlier phases of care.

Conclusions: While early results appear promising, the current application of serologic markers and radiostereometric analysis as a means to assess fracture healing remains limited, and future larger-scale studies are needed to establish concrete and tailored guidelines for use.

Keywords: fracture healing; radiostereometric analysis; serologic markers.

Figure 1

A, Anteroposterior shoulder radiograph of a proximal humerus in a 27-year-old-female at 8 months postsurgery. B, Computed tomography scan showing a clear nonunion at the surgical neck.