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An exploration into the principles and theoretical progress of fracture treatment based on the mechanism of fracture healing

Haiming Ye1,2,3# ,  Qi Yang4# ,  Jiadi Hou5 ,  Xuan Zhang1,2,3 ,  Yien Zheng6 ,  Tiantian Qi1,2,3* ,  Fei Yu7*
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1 Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, China
2 National & Local Joint Engineering Research Centre of Orthopaedic Biomaterials, Shenzhen, Guangdong Province, China
3 Shenzhen Key Laboratory of Orthopaedic Diseases and Biomaterials Research, Shenzhen, Guangdong Province, China
4 Department of Ultrasound Medicine, Peking University Shenzhen Hospital, Shenzhen, Guangdong Province, China
5 Endoscopy Room, Binchen District Municipal Hospital, Binzhou, Shandong Province, China
6 Institute of Macromolecular Chemistry, University of Freiburg, Freiburg, Germany
7 Department of Spine Surgery, Shenzhen Second People’s Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong Province, China
BMT, 69 https://doi.org/10.12336/bmt.24.00069
Submitted: 12 October 2024 | Revised: 12 November 2024 | Accepted: 31 December 2024 | Published: 16 December 2025
© 2025 by the Author(s). Licensee Biomaterials Translational, USA. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 (CC BY-NC-SA 4.0) (https://creativecommons.org/licenses/by-nc-sa/4.0/deed.en)
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Abstract

Fractures are a common category of diseases in the field of orthopaedics with a high incidence in archaeologically obtained bones. These diseases may occur in various human activities. In the context of technological advancement, the annual incidence of fractures is increasing due to traffic accidents, sports injuries, and ageing. Besides, the classification of fracture diseases is also changing, making them one of the main orthopaedic diseases that affect the quality of life of patients and national medical expenditure. There are some basic principles in the treatment of fractures, and the understanding of the causes, types, and pathogenesis of fractures is constantly improved with technological development. Hence, there are sustained efforts to explore fracture treatment methods and examine even widely popular concepts, such as Arbeitsgemeinschaft für Osteosynthesis (AO) and biological osteosynthesis (BO) principles. However, nonhealing fractures, fracture infections, and other treatment problems can still not be eliminated based on these concepts. In addition, some new perspectives on the treatment principles of fractures have been proposed by surgeons based on their clinical experience. In this paper, the latest research results on fracture healing are summarised, and our views and opinions on the application of AO or other new concepts in fracture treatment are also elucidated. During the investigation of the advantages and disadvantages of fracture treatment concepts, the shortcomings of current fracture treatment strategies or theories are also reviewed. These findings may provide clinicians with theoretical support for fracture treatment and inspire scholars to delve into fracture treatment principles.

Keywords
AO principles
Fracture
Healing mechanism
Therapeutic theory
Treatment principles
Funding
This work was supported by grants from National Natural Science Foundation of China (Nos. 82102568, 82172432), Shenzhen Key Medical Discipline Construction Fund (No. SZXK023), Shenzhen “San-Ming” Project of Medicine (No. SZSM202211038), Shenzhen Science and Technology Program (Nos. ZDSYS20220606100602005, JCYJ20220818102815033, KCXFZ20201221173411031, JCYJ20210324110214040), Guangdong Basic and Applied Basic Research Foundation (Nos. 2022A1515220111, 2022B1515120046) and The Scientific Research Foundation of Peking University Shenzhen Hospital (No. KYQD2021099).
Conflict of interest
There is no conflict of interest.
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