Vermesan D, Prejbeanu R, Haragus H, Poenaru D V, Mioc M L, Tatullo M, Abbinante A, Scacco S, Tarullo A, Inchingolo F, Caprio M, Cagiano R
University of Medicine and Pharmacy "Victor Babes" Timisoara, Romania.
Eur Rev Med Pharmacol Sci. 2014 Oct;18(19):2846-50.
Normal healing of fractures is a complex process that relies heavily on a cascade of consecutive activations of immune cells and mediators. This mechanism somewhat overlaps with all processes related to bone metabolism, from the absence of unions to heterotopic ossifications and osteoporosis. We aimed to review and describe this intricate process of bone metabolism with particular focus on abnormal function and to exemplify it with a series of clinical cases which could justify their practical importance. The elbow has great potential for fracture healing but it is very sensitive to prolonged immobilization which can easily lead to intra-articular adherences and stiffness. In addition, the interosseus membrane facilitates communication between the regenerative environments when both radius and ulna are fractured. Such extensive injuries, around the proximal forearm, can lead to heterotopic ossifications and synostosis, which decrease sagittal range of motion through impingement and even block rotational movement through bone bridges. Increased knowledge and awareness of the biological mechanism of fracture healing, will have great improvement in the pharmacological adjuvant treatment of elbow injuries.
骨折的正常愈合是一个复杂的过程，严重依赖于免疫细胞和介质的一系列连续激活。这种机制在某种程度上与所有与骨代谢相关的过程重叠，从骨不连到异位骨化和骨质疏松症。我们旨在回顾和描述这个复杂的骨代谢过程，特别关注其异常功能，并通过一系列临床病例举例说明，以证明其实际重要性。肘部具有很大的骨折愈合潜力，但它对长时间固定非常敏感，这很容易导致关节内粘连和僵硬。此外，当桡骨和尺骨都骨折时，骨间膜有助于再生环境之间的沟通。前臂近端周围的这种广泛损伤可导致异位骨化和关节强直，通过撞击减少矢状面活动范围，甚至通过骨桥阻碍旋转运动。对骨折愈合生物学机制的更多了解和认识，将极大地改善肘部损伤的药物辅助治疗。
