Bone :: Biology

The epidemiology report card in Royal Infirmary of Edinburgh, Scotland reported the incidence of fracture in 2000 which was 5,953 fractures in a population of 534,715 (11.3 in 1,000). (1) In general, the devise has a physiologic repairing process which consists of three basic steps inflammation, proliferation and remodeling and the fracture rout out be healed spontaneously. (2) Failure of physiological regeneration of these steps which big businessman cause the fracture nonunion. (3)This pathologic condition is one of the important complications afterwards treatment fracture which occurs about 5-10% (Littenberg et al., 1998, Tzioupis and Giannoudis, 2007). It leads increase cost for further treatments and morbidness of the patients. (5) Moreover, the standard treatment, surgeon has to glean the bone graft from the iliac big top and the patient also sport a major second operation, for modelling decorticated bone, stigma the non union site bleeding and apply the bone graft. (6 ) there is a report that harvesting bone graft from iliac upper side can lead the painful scar and numbness around the harvest site and affect quality of life of the patient(Schwartz et al., 2009). Fortunately, nonunion can be prevented by many procedures, good surgical technique and proper deep-seated selection. (8) Minimally invasive (MIS) technique becomes to a greater extent popular and there ar many developed modern instruments which are friendly and easy usable. The wages of the development is less tissue traumatized procedure which can preserve the biological around the fracture site. (9) We can also prevent hypertrophic nonunion by providing an enough mechanic stability factor. (10) However, the high energy trauma as well as severe open fracture can make devastation of the soft tissue around the fracture site and mightiness impair the biologic requirement for fracture ameliorate .(11)And in this point the prevention by using MIS technique or even more strong stabilit y implant cannot preventable because the soft tissue have loosen before treatment. Eventually, the atrophic nonunion might occur payable to impair of the biologic component. (12) It is, thus, reasonable to augment with the biologic component for provoke and prevent bone mend in high risk case. The biologic part to support bone healing is consisted of the mediator part such(prenominal) as growth factors or cytokines and cellular part which are regard and orchestrated in fracture healing process. (13) Recently, promote and enhance healing process by difference kinds of mediator have been studied and reported. Interleukin, BMP, VEGF and bone stimulating mediator have positive effect for fracture healing and BMP2 and BMP7 have been accepted for treatment as the biologic stimulated in Human.