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Updated: May 28, 2026
Assessment of Bone Fracture Healing Using Micro-Computed Tomography
Published on: December 9, 2022
Biological and pharmacological factors influencing the fracture healing
Luca Pietrogrande1, Emanuela Raimondo, Andrea Fossali
1Dipartimento di Medicina, Chirurgia e Odontoiatria, Università degli Studi di Milano, Italy. luca.pietrogrande@unimi.it
Abstract:
Many experimental data are available about the positive effect of some molecules on fracture repair, but data on their efficacy in the clinical use in humans are still lacking. Bone Morphogenetic Proteins are currently used in the treatment of delayed unions, but it is necessary to insert them surgically in the fracture site. The only pharmacological factor with clinical data is teriparatide, but more data are needed to confirm its effect on fracture healing in humans, even if experimental data in animals are robust. Data are also available on the effect on bone healing of other molecules used in osteoporosis treatments. Bisphosphonates favour the formation of a bigger callus, mechanically competent, but with a slow rate of remodelling. Estrogens and strontium ranelate have some experimental evidence of stimulating healing process. Robust experimental data are also available on an anti-Sost antibody. Anti-inflammatory drugs have a negative effect on bone healing, interfering with the early phases of inflammation. In conclusion more data, experimental and mainly clinical, are advocated to define whether it is possible to enhance bone healing, even if promising molecules, as teriparatide, are already available.
Insights
Clinical data on enhancing fracture repair are limited. While some molecules like teriparatide show promise, more human studies are needed to confirm their efficacy in bone healing.
Area of Science:
- Orthopedics
- Pharmacology
- Regenerative Medicine
Background:
- Extensive experimental data support molecules enhancing fracture repair.
- Clinical human data on efficacy remain scarce for many agents.
- Current treatments like Bone Morphogenetic Proteins require surgical insertion.
Purpose of the Study:
- To review available data on molecules influencing fracture healing.
- To assess the clinical relevance of experimental findings.
- To identify gaps in knowledge regarding pharmacological enhancement of bone repair.
Main Methods:
- Literature review of experimental and clinical studies.
- Analysis of data on Bone Morphogenetic Proteins, teriparatide, bisphosphonates, estrogens, strontium ranelate, anti-Sost antibodies, and anti-inflammatory drugs.
- Evaluation of effects on callus formation, mechanical competence, and remodeling.
Main Results:
- Teriparatide has some clinical data but requires further investigation.
- Bisphosphonates increase callus size but slow remodeling.
- Estrogens, strontium ranelate, and anti-Sost antibodies show experimental promise.
- Anti-inflammatory drugs negatively impact early bone healing phases.
Conclusions:
- More experimental and clinical data are essential to validate molecules for enhanced bone healing.
- Teriparatide is a promising pharmacological option, but more research is needed.
- Understanding the precise effects of various agents is crucial for clinical application.
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