Vascular Inflammation and Endothelial Dysfunction in Fracture Healing

Angiogenesis is an important step in bone fracture healing. In this article, we report on the healing of long bone fractures, and the involvement of the vascular and the inflamma­tory systems in the process.

We conducted a prospective study of 20 healthy adults with traumatic long bone fracture. One week after fracture, and then 1 month later, we evaluated markers of inflammation: vascular respon­siveness (brachial endothelial func­tion and ankle brachial index) and inflammatory and cytokine levels osteopontin [OPN], E-selectin, and vascular endothelial growth factor [VEGF]).

Long bone fractures caused intense vascular and inflammatory responses, represented by high lev­els of OPN, E-selectin, and VEGF. In vivo measurements demonstrat­ed severe endothelial dysfunction, which could support the idea that the vascular system is recruited to build new blood vessels that sup­port bone regeneration.