CURRENT CONCEPTS IN ADULTS UPPER EXTREMITY FRACTURES

21452Ugur_TiftikciCurrent_Consept_in_adults.kapak

FACTORS INFLUENCING FRACTURE HEALING: AGE, GENDER AND GENETIC PREDISPOSITION

Adnan Çakar

Niğde Training and Research Hospital, Department of Orthopedics and Traumatology, Niğde, Türkiye

Çakar A. Factors Influencing Fracture Healing: Age, Gender and Genetic Predisposition. In: Tiftikçi U, Erdoğan E, Ergün C, Güneş Z, editors. Current Concepts in Adults Upper Extremity Fractures. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.381-386.

ABSTRACT

Fractures are the most common major organ traumatic injuries in humans, and 10% of them do not heal without complications. A fracture is a soft tissue injury in which the bone and surrounding soft tissue, periosteum, and Haversian canals are damaged. Unlike other tissues, bone tissue heals with biochemical and biomechanical remodeling. Fracture healing is divided into primary and secondary bone healing. Fracture healing basically consists of the stages of hematoma formation, granulation formation, callus formation, and bone remodeling. Fracture healing is a biological and mechanical process in which many patient-related and fracture-related factors play a role together. The duration for fracture healing is 4-16 weeks, depending on the location and type of fracture, the status of surrounding soft tissues, the severity of the damage and patient-related factors. The aim of fracture healing is to restore bone integrity and restore the patient’s previous functional status. Fracture healing is affected by a number of patient-related conditions such as age, gender, genetic predisposition, smoking, alcoholism, diabetes mellitus, obesity, malnutrition, use of certain drugs that have been proven to have negative effects on fracture healing, etc. The possible negativities in these factors lead to delayed union and nonunion, leading to disability, loss of work capacity, functional and psychosocial disorders. In these cases, the orthopedic physician can only manage the treatment to ensure the necessary and desired fracture healing by understanding the biological and mechanical aspects of this process well. The clinician should perform diagnosis and treatment by considering the factors influencing fracture healing, thus preventing possible complications.

Keywords: Fracture; Fracture healing; Gender; Genetic predisposition; Nonunion; Malunion

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