Outcome in fracture healing: a review.

This editorial reviews outcome measures in fracture healing. Individually radiological and clinical methods are inaccurate, but together provide a good indicator in clinical practice when a fracture has healed. Other quantitative methods are not practical. Vibrational analysis of fracture healing is complex and limited to research at present. Indirect fracture stiffness measurement is possible and has been used in clinical trials. Pin loosening reduces accuracy. The measurement of direct fracture stiffness has been validated and using this a decrease in re-fracture rate and a reduction of time to independent weight bearing (on average 3 weeks) was found. The system is accurate and simple to use in the clinical setting and allows the rate of healing to be monitored in fractures. Studies using poor outcome measures should be interpreted with care. The study of healing fractures is no exception.