Fracture Healing

             

Scientific Federation invites all the participants from all over the world to attend International Summit on Rheumatology &Orthopedics during September 24-25 2018 at Madrid, Spain. Which includes Keynote presentations, Oral talks, Poster presentations and Exhibitions. 

Fractures are the most common large-organ, traumatic injuries to humans. The repair of bone fractures is a postnatal regenerative process that recapitulates many of the ontological events of embryonic skeletal development. Although fracture repair usually restores the damaged skeletal organ to its pre-injury cellular composition, structure and bio mechanical function, about 10% of fractures will not heal normally. The developmental progression of fracture healing at the tissue, cellular and molecular levels. Innate and adaptive immune processes are discussed as a component of the injury response, as are environmental factors, such as the extent of injury to the bone and surrounding tissue, fixation and the contribution of vascular tissues.

Fracture healing and bone repair are postnatal processes that mirror many of the ontological events that take place during embryonic development of the skeleton and have been extensively reviewed elsewhere. The recapitulation of these ontological processes is believed to make fracture healing one of the few postnatal processes that is truly regenerative, restoring the damaged skeletal organ to its pre-injury cellular composition, structure and bio- mechanical function. Interestingly, a comparison of the transcription of mouse callus tissues across a 21-day period of fracture healing showed that about one-third of the mouse homologous of the genes expressed by human embryonic stem cells are preferentially induced. Many of the homoerotic genes that control appendices limb development also show increased expression during fracture healing. We place these biological processes in the context of how trauma and the immune system, as a component of the injury response, are related to the developmental aspects of fracture healing. We then review the relationships between ontogeny and the recovery of skeletal function. Finally, we focus on specific biophysical, local and systemic therapies that have been used to promote fracture healing.

Optimizing conditions for the harvest, selection, expansion and formulation of osteogenic stem cell preparations is needed to advance the field of skeletal healing and to set the stage for developing new local and systemic therapies. We also need to develop better delivery systems for stem cells, growth factors and osteoinductive substances, and to explore systemic applications of osteogenic agents. Identification of appropriate experimental settings and measurable, meaningful clinical endpoints for human clinical trial design are also required.