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The early phase of fracture healing is dominated by the fracture haematoma.
Therefore, in accordance with our results, IL-6 appears to have a pivotal role in the early phase of fracture healing, probably through the increase in the pro-osteoclastogenic stimuli.
The variation encountered in these elderly fragility fracture patients is similar to the findings obtained in animal models studies [8] and in healthy younger subjects [18] where the inflammatory phase occurs before day 3 post-fracture, being IL-6 a crucial player in this early phase of fracture healing.
The active role of osteoclast during the early phase of fracture healing was already described in sheep where it was proposed that these cells not only resorb bone but adjust the system, together with osteoblasts, in order to improve bone strength [25].
Therefore, acceleration of healing during the early phase of fracture repair is particularly relevant in the clinical setting.
This finding suggests that slight comminution could have an influence on the early phase of fracture healing, but its influence of the final healing is still unclear.
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This suggested that a slight comminuted fracture created using the current modified device gave minimal influence at the early phase of the fracture healing.
This is in line with recently published data from an animal model supporting an important role for MCP-1 in the early phase of stress fracture repair and activated remodeling [ 30].
However a cortical radiolucency without a periosteal reaction or callus formation might be visible in the early phase of a stress fracture.
The criteria were deliberately selected to primarily reflect the quality of care in the early phase of a hip fracture as in-hospital care is the focus of DNIP.
Using a murine model of fragility fractures, we found that local rhTNF treatment improved fracture healing during the early phase of repair.
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