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Genetic Influence of Fracture Nonunion (FNU): A Systematic Review
Mir Sadat-Ali1, Hussain K Al-Omar2, Khalid W AlTabash1
1The Department of Orthopedic Surgery, King Fahd Hospital of the University, Imam AbdulRahman Bin Faisal University, Dammam, Saudi Arabia.
Pharmacogenomics and Personalized Medicine
|June 12, 2023
Summary
Genetic factors significantly influence fracture nonunion (FNU). This review identified specific genes and polymorphisms associated with FNU, suggesting genetic testing could guide aggressive treatment for better healing outcomes.
Area of Science:
- Orthopedics
- Genetics
- Molecular Biology
Background:
- Fracture nonunion (FNU) affects approximately 15% of fractures.
- FNU leads to repeated surgeries and prolonged patient suffering.
Purpose of the Study:
- To systematically review genes and polymorphisms influencing fracture nonunion.
- To identify genetic predispositions for delayed fracture healing.
Main Methods:
- Comprehensive literature search from 2000 to July 2022 in major databases (PubMed, EMBASE, Cochrane).
- Keywords included 'nonunion of fractures', 'genetic influence', and 'GWAS'.
- Included 10 studies (9 case-controlled, 1 GWAS) analyzing data from 4402 patients.
Main Results:
- Nine studies identified polymorphisms in genes such as ANXA3, BMP2, CALY, CYR61, FGFR1, IL1β, NOG, NOS2, PDGF, and TACR1.
- These genetic variations are associated with an increased susceptibility to fracture nonunion.
- Genome-Wide Association Studies (GWAS) contributed to identifying these genetic links.
Conclusions:
- Genetic analysis, including single nucleotide polymorphism (SNP) studies, is recommended for patients with early fracture nonunion.
- Identifying genetic predispositions can facilitate the selection of more aggressive and effective treatment strategies.
- This approach aims to improve fracture healing and reduce prolonged morbidity.
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