A review of bone fracture healing modelling: from mechanobiological theory to personalized rehabilitation protocols

IF 3.9 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Bone Pub Date : 2026-01-01 Epub Date: 2025-10-21 DOI:10.1016/j.bone.2025.117688

Lunjian Li , Minoo Patel , Lihai Zhang

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引用次数: 0

Abstract

Despite standard rehabilitation protocols, many patients still suffer from limited mobility, delayed union, or even non-union. This underscores the need for personalized rehabilitation protocols. Fracture healing is a dynamic process governed by the interplay of mechanical stimuli and biochemical signalling pathways. This review first summarizes current understanding of the biological and mechanobiological mechanisms that regulate bone repair. It also discusses different simulation models, including the finite element method (FEM), agent-based models (ABM), reaction–diffusion models (RDM), and machine learning (ML), and evaluates their respective strengths. Recent advances in patient-specific models are also reviewed, particularly those integrating CT-derived geometry, bone properties, and musculoskeletal (MSK) loading. These approaches enable individualized predictions of healing and can inform clinical rehabilitation strategies. Finally, the key challenges and future priorities for implementing these technologies in clinical practice are discussed, providing insights to support the development of more precise and patient-specific fracture care.

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骨折愈合模型的综述：从机械生物学理论到个性化康复方案。

尽管有标准的康复方案，许多患者仍然受到活动受限，延迟愈合，甚至不愈合的困扰。这强调了个性化康复方案的必要性。骨折愈合是一个机械刺激和生化信号通路相互作用的动态过程。这篇综述首先总结了目前对调节骨修复的生物学和机械生物学机制的理解。它还讨论了不同的仿真模型，包括有限元法（FEM）、基于代理的模型（ABM）、反应扩散模型（RDM）和机器学习（ML），并评估了它们各自的优势。本文还回顾了患者特异性模型的最新进展，特别是那些整合了ct衍生几何、骨特性和肌肉骨骼（MSK）载荷的模型。这些方法可以实现个性化的康复预测，并可以为临床康复策略提供信息。最后，讨论了在临床实践中实施这些技术的关键挑战和未来的优先事项，为支持更精确和患者特异性骨折护理的发展提供了见解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Bone 医学-内分泌学与代谢

CiteScore

8.90

自引率

4.90%

发文量

264

审稿时长

30 days

期刊介绍： BONE is an interdisciplinary forum for the rapid publication of original articles and reviews on basic, translational, and clinical aspects of bone and mineral metabolism. The Journal also encourages submissions related to interactions of bone with other organ systems, including cartilage, endocrine, muscle, fat, neural, vascular, gastrointestinal, hematopoietic, and immune systems. Particular attention is placed on the application of experimental studies to clinical practice.