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Osteoimmunology: Effects of Standard Orthopaedic Interventions on Inflammatory Response and Early Fracture Healing

Schneider, Prism S. MD, PhD, FRCSC; Sandman, Emilie MD, MSc, FRCSC; Martineau, Paul A. MDCM, FRCSC

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: May 15, 2018 - Volume 26 - Issue 10 - p 343-352
doi: 10.5435/JAAOS-D-16-00646
Review Article

Achieving fracture union is highly dependent on the initial inflammatory phase of fracture healing, which is influenced by both the local and systemic inflammatory environments. The rapidly emerging field of osteoimmunology involves the study of the interactions between the immune system and the skeletal system. Recent research has advanced the current state of knowledge regarding the effects of the surrounding soft-tissue injury, fracture hematoma, and the method of fracture fixation on the inflammatory phase of fracture healing. Acute systemic inflammation, as seen in patients with polytrauma, and chronic systemic inflammation, as seen in patients with diabetes or rheumatoid arthritis, affects the inflammatory phase of fracture healing. The use of NSAIDs can influence early fracture healing. Understanding the effects of standard orthopaedic interventions on the local and systemic inflammatory responses and early fracture healing is important for optimizing fracture union.

From the Departments of Surgery and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada (Dr. Schneider), the Department of Surgery, Montreal Sacré-Coeur Hospital, Montreal, Quebec, Canada (Dr. Sandman), and the Department of Surgery, McGill University Health Centre, Montreal, Quebec (Dr. Martineau).

Dr. Schneider or an immediate family member is a member of a speakers’ bureau or has made paid presentations on behalf of Stryker and serves as paid consultant to Amgen. Dr. Sandman or an immediate family member has received research or institutional support from Smith & Nephew. Dr. Martineau or an immediate family member is a member of a speakers’ bureau or has made paid presentations on behalf of and has received research or institutional support from Smith & Nephew.

Copyright 2018 by the American Academy of Orthopaedic Surgeons.
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