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Fig. 7 | In Silico Cell and Tissue Science

Fig. 7

From: Computational modeling of bone fracture non-unions: four clinically relevant case studies

Fig. 7

Fracture healing evolution under several loading conditions and treatment strategies. Evolution of the fibrous, cartilaginous and bone tissue fractions in the fracture callus under several loading conditions (the mechanical stimulus (i.e. interstitial fluid flow) influences angiogenesis, intramembranous and endochondral ossification): a healing under normal biological and mechanical conditions, b overloading (400 % of the normal load). cf depict the results of various treatment strategies for overload-induced non-unions (the mechanical stimulus (i.e. interstitial fluid flow) influences proliferation, osteogenic differentiation, bone matrix production and endochondral ossification). Treatments of overload-induced non-unions started at 3 weeks post fracture (PFW3) as, by then, the first signs of endochondral ossification should have been visible in a normal healing process. The star symbol indicates the timing of the schematically depicted treatment. c stabilization of the callus area after 3 weeks of healing under unstable conditions (overloading) does not result in recapitulation of normal-healing processes, d administration of additional osteogenic growth factors (OGF, gb) at PFW3 without stabilization does not result in recapitulation of the normal healing process, e stabilization of the callus area in combination with the administration of sufficient osteogenic growth factors (0.1 mg/ml1) at PFW3 results in recapitulation of the normal healing process. f stabilization of the callus area in combination with the administration of osteogenic growth factors in a lower concentration (0.01 mg/ml) at PFW3 results in a slower recapitulation of the normal healing process when compared with (biv). (with kind permission from Springer Science + Business Media: Geris et al. [51], Fig. 6; adapted from [51, 64])

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