Stimulation of Fracture Healing: Osteobiologics, Bone Stimulators, and Beyond : Journal of Orthopaedic Trauma

Journal Logo

Editorial Comment

Stimulation of Fracture Healing: Osteobiologics, Bone Stimulators, and Beyond

Bhandari, Mohit MD, MSc; Schemitsch, Emil H MD

Author Information
Journal of Orthopaedic Trauma 24():p S1, March 2010. | DOI: 10.1097/BOT.0b013e3181d2d683
  • Free

By 2020, disability from traffic accidents, the major cause of fractures, is estimated to rank in the top three of all-cause disability from disease. Accelerated urbanization and industrialization in India and China, which represent 40% of the world's population, have resulted in an alarming increase in traumatic injuries. A vehicular accident is reported every 3 minutes and a death every 10 minutes on these roads. For every death, three patients survive and live with disability.

With the increasing burden of trauma (and therefore trauma-related fractures), identifying best evidence in novel therapeutics to enhance healing remains paramount. The spectrum of therapies includes noninvasive devices, locally applied biologics, systemically administered injectables, and future promise of nanotechnology and gene therapy.

The evidence for fracture healing technologies will only be as valid as the primary research. Optimal evidence will require improved methods in the design and execution of fracture healing trials. Developing novel outcome measures to assess fracture healing and overcoming the challenges of multicenter randomized trials require a parallel effort.

This symposium represents an overview of the existing and emerging technologies in the acceleration of fracture healing and provides context to the design of fracture healing trials.

One can argue that with the current implants and techniques in fracture management, innovation is unlikely to come in another implant, but rather a biologic-a drug or device that further enhances the healing potential of fractures treated with modern day implant fixation. In a time when early return to function sits atop the priorities for injured patients, we must critically appraise existing technologies, understand the scope of emerging technologies, and embrace those that provide a valid evidence base at a reasonable cost.

Mohit Bhandari, MD, MSc

Emil H. Schemitsch, MD

From the Division of Orthopaedic Surgery, McMaster University and University of Toronto, Toronto, Ontario, Canada

© 2010 Lippincott Williams & Wilkins, Inc.