Department of Orthopaedics, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Orthop Surg. 2021 Apr;13(2):369-375. doi: 10.1111/os.12885. Epub 2021 Jan 25.
Secondary fracture healing is a complex multi-stage process in which the mechanical environment plays a key role. The use of an appropriate mechanical stimulation such as strain is conducive to tissue formation between fracture ends, thus aiding the healing process. However, if the strain is too large or too small, the biological behavior of the cells involved in bone healing will be affected, resulting in non-union or delayed healing. In this review, we summarize the current state of knowledge regarding the effect of strain on cells that play a role in the fracture-healing process. Overall, the related literature suggests that selection of an adequate strain promotes fracture healing through the stimulation of angiogenesis and osteogenesis, along with inhibition of osteoclast differentiation and bone resorption. However, standardized methods for the application of mechanical stimulation are lacking, and a unified consensus on the mechanism by which strain promotes cell differentiation has not yet been reached. These issues, therefore, deserve further investigation.
骨折二期愈合是一个复杂的多阶段过程，其中力学环境起着关键作用。使用适当的机械刺激，如应变，有利于在骨折端之间形成组织，从而促进愈合过程。然而，如果应变过大或过小，参与骨愈合的细胞的生物学行为将会受到影响，导致不愈合或愈合延迟。在这篇综述中，我们总结了目前关于应变对骨折愈合过程中起作用的细胞的影响的知识状态。总的来说，相关文献表明，选择适当的应变可以通过刺激血管生成和成骨，同时抑制破骨细胞分化和骨吸收来促进骨折愈合。然而，机械刺激的应用缺乏标准化的方法，应变促进细胞分化的机制尚未达成统一共识。因此，这些问题值得进一步研究。
