The treatment of bone fractures hasn’t significantly changed in years – healing generally takes 6-to-8 weeks – but a Michigan State University veterinary scientist is looking at ways to improve the process, the University said.
Kurt Hankenson received grants totaling $4.2 million from the National Institutes of Health ($2.5 million) and the Department of Defense ($1.7 million). The latter money is being used to explore a technique called notch signaling that might accelerate healing.
“Notch signaling is a pathway in the body that regulates cells that form bone,” Hankenson said. “We can enhance this activity by activating this pathway with certain proteins that bind together.”
Those proteins are combined with collagen sponges, and then implanted into the injury. In studies involving mice, “significant regeneration and healing of bone” occurred. Further studies may attempt to use the technique on humans.
Meantime, the NIH project explores how proteins manage the way the body begins – or potentially inhibits – the healing process.
A protein known as thrombospondin sometimes is at odds with broken blood vessels that are repairing themselves after a fracture to improve healing. Those proteins, which regulate how a body responds to injury, may become overstimulated and inhibit healing.
Hankenson’s team, which includes fellow MSU Professor Leslie A. Kuhn and researchers from the University of California at San Francisco, the University of Pennsylvania and the University of Pittsburgh, is looking for ways to block those proteins.
Fracture care is important because 1-in-40 people suffer a fracture each year in the United States, Hankenson said in the YouTube video above. That equals about eight million fractures. Roughly 13% of those fractures – or 1 million injuries – don’t properly heal.
In the military, more than half of the combat-related injuries are to bone, muscle or portions of the musculoskeletal system. During Operation Iraqi Freedom and Operation Enduring Freedom, a quarter of the injuries to soldiers’ arms, hands, legs and feet were fractures.
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How Bones Heal
As mentioned above, bone fractures typically take 6-to-8 weeks to significantly heal, according to foothealthfacts.org. The process has three stages.
The first stage lasts several days and features inflammation. Bone breaks are accompanied by inflammation and localized bleeding and clotting. That produces the structure for new bone to grow.
Fibrous tissue and cartilage, which is called soft callus, replaces the clotted blood. Hard bone replaces the soft callus as healing continues.
The final phase is known as bone remodeling – the bone continues to grow and returns to its original shape as everything in the impacted area returns to normal. This can take several months.
Not counting Hankenson’s research, there are a few measures patients can now take to assure optimal recovery. Those include a healthy diet, smoking cessation (smoking constricts blood vessels, which decreases circulation) and blood sugar control in diabetics
Immobilization of the fractured bones also helps with bone repair. Immobilization may include a cast or screws, plates or wires that keep a bone from moving.
“If we can help people to heal faster and more effectively, then our mission to improve quality of life and overall health following a bone injury can become a reality,” Hankenson said.
