In the process of fracture healing, there are many cellular and molecular events that are regulated by mechanical stimuli and biochemical signals. To explore the unknown mechanisms underlying bone fracture healing, optimal fixation configurations, and the design of new treatment strategies, computational healing models provide a good solution. With the simulation of mechanoregulatory healing models, bioregulatory healing models and coupled mechanobioregulatory healing models, healing outcomes can be predicted. In this review, first, we provide an overview of current computational healing models. Their clinical applications are also presented. Then, the limitations of current models and their corresponding solutions are discussed in this review. Finally, future potentials are presented in this review. Multiscale modeling from the intracellular level to the tissue level is essential, and more clinical applications of computational healing models are required in future research.

A dynamic model regulated by both biphasic poroelastic finite element analysis and fuzzy logic control was established. Fuzzy logic control was an easy and comprehensive way to simulate the tissue differentiation process, and it is convenient for researchers and medical experts to communicate with one another to change the fuzzy logic rules and improve the simulation of the tissue differentiation process. In this study, a three-dimensional fracture healing model with two different interfragmentary movements (case A: 0.25 mm and case B: 1.25 mm) was analysed with the new set-up computational model. As the healing process proceeded, both simulated interfragmentary movements predicted a decrease and the time that the decrease started for case B was later than that for case A. Compared with experimental results, both cases corresponded with experimental data well. The newly established dynamic model can simulate the healing process under different mechanical environments and has the potential to extend to the multiscale healing model, which is essential for reducing the animal experiments and helping to characterise the complex dynamic interaction between tissue differentiations within the callus region.

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