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Current Osteoporosis Reports
Published in: Current Osteoporosis Reports 1/2024

Open Access 18-01-2024 | Fracture Healing

Role of the Neurologic System in Fracture Healing: An Extensive Review

Authors: Reginald S. Parker, Murad K. Nazzal, Ashlyn J. Morris, Jill C. Fehrenbacher, Fletcher A. White, Melissa A. Kacena, Roman M. Natoli

Published in: Current Osteoporosis Reports | Issue 1/2024

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Abstract

Purpose of Review

Despite advances in orthopedics, there remains a need for therapeutics to hasten fracture healing. However, little focus is given to the role the nervous system plays in regulating fracture healing. This paucity of information has led to an incomplete understanding of fracture healing and has limited the development of fracture therapies that integrate the importance of the nervous system. This review seeks to illuminate the integral roles that the nervous system plays in fracture healing.

Recent Findings

Preclinical studies explored several methodologies for ablating peripheral nerves to demonstrate ablation-induced deficits in fracture healing. Conversely, activation of peripheral nerves via the use of dorsal root ganglion electrical stimulation enhanced fracture healing via calcitonin gene related peptide (CGRP). Investigations into TLR-4, TrkB agonists, and nerve growth factor (NGF) expression provide valuable insights into molecular pathways influencing bone mesenchymal stem cells and fracture repair. Finally, there is continued research into the connections between pain and fracture healing with findings suggesting that anti-NGF may be able to block pain without affecting healing.

Summary

This review underscores the critical roles of the central nervous system (CNS), peripheral nervous system (PNS), and autonomic nervous system (ANS) in fracture healing, emphasizing their influence on bone cells, neuropeptide release, and endochondral ossification. The use of TBI models contributes to understanding neural regulation, though the complex influence of TBI on fracture healing requires further exploration. The review concludes by addressing the neural connection to fracture pain. This review article is part of a series of multiple manuscripts designed to determine the utility of using artificial intelligence for writing scientific reviews.
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Metadata
Title
Role of the Neurologic System in Fracture Healing: An Extensive Review
Authors
Reginald S. Parker
Murad K. Nazzal
Ashlyn J. Morris
Jill C. Fehrenbacher
Fletcher A. White
Melissa A. Kacena
Roman M. Natoli
Publication date
18-01-2024
Publisher
Springer US
Published in
Current Osteoporosis Reports / Issue 1/2024
Print ISSN: 1544-1873
Electronic ISSN: 1544-2241
DOI
https://doi.org/10.1007/s11914-023-00844-0

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