Biomechanical concepts of fracture healing in weight-bearing long bones.

Fracture healing is a complex process in which mechanical forces are essential for the regeneration of bone tissue. Mechanical loading can induce osteogenesis through the process of mechanotransduction. Current data on how mechanical loading stimulates fracture healing in weight-bearing long bones are presented. The role of mechanosensors, loading-induced interstitial fluid flow, streaming potentials, the biophysical environment of the fracture gap and the significance of timing, strains and distribution of mechanical stimulation in long bone fractures are reviewed. Remodelling and biomechanical concepts of fracture healing are discussed from a clinical perspective.