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Great basic science library builder regarding fracture healing.
Please post some thoughts regarding clinical implications from the information presented in this review
Cheers
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Definitely a good read. This will be useful going forward on many fronts-identification of modifiable and non-modifiable risk factors to guide exercise progression based on healing, education on modifiable risk factors and emphasizing importance of lifestyle changes, discussion when referring with suspicion of non-union.
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This article serves as a good reminder of how much goes into healing. The article reminds me of Lorimer Moseley’s iceberg analogy. I feel the overwhelming detail in this article is analogous to the portion of the iceberg that is underwater. This information is beneficial to know. However, more importantly, is the portion of the iceberg above water – the part we should share and educate our patients on. With that, I felt relearning many of the modifiable risk factors that play a role in tissue healing most beneficial. Further, this is likely where clinicians can immediately work to begin changing their practice by providing thorough patient education.
One concept that stood out to me was the effects of opioid use on tissue healing. This modifiable risk factor was more foreign to me. I’m curious to know if it was new to anyone else?
The large portion of the patient demographic that I see are post-surgical. Nearly all of these patients are age 50+ with several comorbidities such as diabetes, obesity, not to mention tobacco users. It would seem that placing these comorbidity-riddled post-surgical patients on opioids to be a contraindication. However, it is something that I see quite frequently. Clearly, opioids work well post-op to void pain. However, at what point do the cons outweigh the pros?
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