Spanoudakis Emmanuel, Vampertzis Themistoklis, Wadia Farokh, Rad Darius Rares, Barmpagianni Christina, Zervos Ioannis A, Tsiridis Eleftherios, Galanis Nikiforos
University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.
Aristotle University of Thessaloniki, Thessaloniki, Greece.
Eur J Orthop Surg Traumatol. 2025 Jun 4;35(1):233. doi: 10.1007/s00590-025-04295-4.
Using botulinum toxin (BoNT) as an adjunct in fracture management is a novel approach with the potential to improve clinical outcomes, particularly in atypical fractures and patients with concurrent neuromuscular disorders. This scoping review explores the literature on BoNT's effectiveness in facilitating fracture healing and immobilisation across various fracture types.
The PubMed, Embase, and Cochrane databases were searched with defined operators. Two investigators conducted independent searches, which were combined. Animal studies, case reports, case series, cohort reviews and randomised control trials were included.
Fifty studies were identified for screening, from which 15 studies were included in the review. The findings highlight mixed outcomes in BoNT's role in enhancing bone healing and reducing muscle-induced displacement. While BoNT injections demonstrated potential benefits in specific cases, such as atypical fractures, periprosthetic fractures and fractures in patients with motor dysfunctions, results from animal studies were inconsistent, showing varied effects on callous formation and bone mineral density.
Clinical applications of BoNT in fracture management indicate its utility as an immobilisation agent to promote fracture healing and reduce complications. However, this review highlights that further research is necessary to bridge the gap between experimental and clinical studies and to clarify BoNT's effectiveness in different use cases.
将肉毒杆菌毒素（BoNT）用作骨折治疗的辅助手段是一种新方法，有可能改善临床疗效，尤其是在非典型骨折和并发神经肌肉疾病的患者中。本综述探讨了关于BoNT在促进各种骨折类型的骨折愈合和固定方面有效性的文献。
使用定义好的检索词在PubMed、Embase和Cochrane数据库中进行检索。两名研究人员独立进行检索，之后合并检索结果。纳入动物研究、病例报告、病例系列、队列综述和随机对照试验。
共识别出50项研究用于筛选，其中15项研究被纳入本综述。研究结果凸显了BoNT在促进骨愈合和减少肌肉引起的移位方面的作用存在不同结果。虽然BoNT注射在特定情况下显示出潜在益处，如非典型骨折、假体周围骨折和运动功能障碍患者的骨折，但动物研究结果并不一致，对骨痂形成和骨密度的影响各不相同。
BoNT在骨折治疗中的临床应用表明其作为一种固定剂在促进骨折愈合和减少并发症方面的效用。然而，本综述强调需要进一步研究以弥合实验研究和临床研究之间的差距，并阐明BoNT在不同应用案例中的有效性。
