Impaired healing of fragility fractures in type 2 diabetes: clinical and radiographic assessments and serum cytokine levels

Abstract

Fragility fracture healing is impaired in diabetic patients. Radiographic and molecular patterns confirmed that the most compromised fracture-healing phase is at 4 weeks after surgery, during callus mineralization.

The neurosurgical wound and factors that can affect cosmetic, functional, and neurological outcomes

“…Free radicals also inhibit the healing metabolic function of keratinocytes in wound healing . Poorly controlled diabetes further impairs healing of fractures, which can affect neurosurgery patients with traumatic injuries to the skull and spine . High serum glucose levels inhibit human fibroblast cell migration in wound healing, causing a decrease in collage deposition, which reduces the tensile strength of the wound .…”

“…20 Poorly controlled diabetes further impairs healing of fractures, which can affect neurosurgery patients with traumatic injuries to the skull and spine. 21 High serum glucose levels inhibit human fibroblast cell migration in wound healing, causing a decrease in collage deposition, which reduces the tensile strength of the wound. 22 In cases of increased incision length, the force on the wound edges is greater because there are less fixated portions of skin.…”

The effect of experimental diabetes and glycaemic control on guided bone regeneration: histology and gene expression analyses

“…Diabetes mellitus has been associated with the occurrence of a series of complications involving the skeletal system, collectively referred to as "diabetic bone disease" or "diabetic osteopathy" (Bouillon 1991). The diabetic skeletal phenotype presents the following features: (i) diminished linear bone growth during the pubertal growth spurt in adolescents with diabetes (Salerno et al 1997;Bizzarri et al 2014); (ii) reduction in bone mineral density and increased risk for occurrence of osteopenia and osteoporosis (Vestergaard 2007); (iii) increased fracture risk (Janghorbani et al 2007); (iv) poor osseous healing characteristics and impaired bone regeneration potential (Cozen 1972;Choi et al 2014;Liuni et al 2015).…”

Musculoskeletal Regeneration, Rehabilitation, and Plasticity Following Traumatic Injury

“…For instance, wound effluent from severely traumatized extremities has been shown to have extremely heightened levels of inflammatory cytokines that associated with poor healing outcomes to include heterotopic ossification [59]. Similarly, patients with inflammatory comorbidities, such as diabetes, have demonstrated impaired healing of fragility fractures compared to agematched controls that associates with systemic levels of inflammatory cytokines [60]. These findings are further supported in animal models of polytrauma and open fracture in which heightened and prolonged systemic and local immune responses are associated with impairment of fracture healing; the attenuation thereof using either systemic pharmacological agents (e. g. FK506) or muscle tissue replacement successfully restored the rate of fracture healing [49,[61][62][63][64].…”