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Can Optimizing the Mechanical Environment Deliver a Clinically Significant Reduction in Fracture Healing Time?

The impact of the local mechanical environment in the fracture gap on the bone healing process has been extensively investigated. Whilst it is widely accepted that mechanical stimulation is integral to callus formation and secondary bone healing, treatment strategies that aim to harness that potenti...

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Autores principales: Barcik, Jan, Epari, Devakara R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8234230/
https://www.ncbi.nlm.nih.gov/pubmed/34207370
http://dx.doi.org/10.3390/biomedicines9060691
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author Barcik, Jan
Epari, Devakara R.
author_facet Barcik, Jan
Epari, Devakara R.
author_sort Barcik, Jan
collection PubMed
description The impact of the local mechanical environment in the fracture gap on the bone healing process has been extensively investigated. Whilst it is widely accepted that mechanical stimulation is integral to callus formation and secondary bone healing, treatment strategies that aim to harness that potential are rare. In fact, the current clinical practice with an initially partial or non-weight-bearing approach appears to contradict the findings from animal experiments that early mechanical stimulation is critical. Therefore, we posed the question as to whether optimizing the mechanical environment over the course of healing can deliver a clinically significant reduction in fracture healing time. In reviewing the evidence from pre-clinical studies that investigate the influence of mechanics on bone healing, we formulate a hypothesis for the stimulation protocol which has the potential to shorten healing time. The protocol involves confining stimulation predominantly to the proliferative phase of healing and including adequate rest periods between applications of stimulation.
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spelling pubmed-82342302021-06-27 Can Optimizing the Mechanical Environment Deliver a Clinically Significant Reduction in Fracture Healing Time? Barcik, Jan Epari, Devakara R. Biomedicines Review The impact of the local mechanical environment in the fracture gap on the bone healing process has been extensively investigated. Whilst it is widely accepted that mechanical stimulation is integral to callus formation and secondary bone healing, treatment strategies that aim to harness that potential are rare. In fact, the current clinical practice with an initially partial or non-weight-bearing approach appears to contradict the findings from animal experiments that early mechanical stimulation is critical. Therefore, we posed the question as to whether optimizing the mechanical environment over the course of healing can deliver a clinically significant reduction in fracture healing time. In reviewing the evidence from pre-clinical studies that investigate the influence of mechanics on bone healing, we formulate a hypothesis for the stimulation protocol which has the potential to shorten healing time. The protocol involves confining stimulation predominantly to the proliferative phase of healing and including adequate rest periods between applications of stimulation. MDPI 2021-06-18 /pmc/articles/PMC8234230/ /pubmed/34207370 http://dx.doi.org/10.3390/biomedicines9060691 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Barcik, Jan
Epari, Devakara R.
Can Optimizing the Mechanical Environment Deliver a Clinically Significant Reduction in Fracture Healing Time?
title Can Optimizing the Mechanical Environment Deliver a Clinically Significant Reduction in Fracture Healing Time?
title_full Can Optimizing the Mechanical Environment Deliver a Clinically Significant Reduction in Fracture Healing Time?
title_fullStr Can Optimizing the Mechanical Environment Deliver a Clinically Significant Reduction in Fracture Healing Time?
title_full_unstemmed Can Optimizing the Mechanical Environment Deliver a Clinically Significant Reduction in Fracture Healing Time?
title_short Can Optimizing the Mechanical Environment Deliver a Clinically Significant Reduction in Fracture Healing Time?
title_sort can optimizing the mechanical environment deliver a clinically significant reduction in fracture healing time?
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8234230/
https://www.ncbi.nlm.nih.gov/pubmed/34207370
http://dx.doi.org/10.3390/biomedicines9060691
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