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- Talk
- 19/09/2023
- UK
Why Fractures Don't Heal and When Is This Determined?
Description
This presentation by Hamish Simpson covers recent insights into bone maintenance, fracture healing, and the biological mechanisms underpinning these processes. Starting with preclinical studies, Simpson outlines the critical roles of bone remodeling and wound healing in fracture repair. He discusses how normal mechanical loading leads to micro-cracks in bones and how a unique biological mechanism, primarily involving osteocytes and osteoclasts, is responsible for repairing these damages, underlining its implications for clinical practices.
He dives into the challenges of assessing fracture healing, emphasizing the importance of monitoring for nonunion—where healing fails to progress. Simpson highlights that bisphosphonates can adversely affect primary bone healing by inhibiting osteoclast activity, leading to potential complications in patients undergoing treatment for fragility fractures or trauma.
The presentation also touches on wound healing in relation to fracture repair, clarifying that the overlapping stages of healing necessitate a nuanced approach to treatment. He suggests that advancements in areas like osteoimmunology and imaging technologies may enhance our capabilities to monitor healing and detect failures.
In the latter sections, Simpson discusses nonunion complications and the need for early intervention strategies and highlights promising areas of ongoing research aimed at identifying biomarkers that can signal healing progress. He concludes that a combination of different tools and markers is essential for accurately assessing various stages of fracture healing and ensuring optimal recovery for patients.