Bone healing: little secrets.

The development of new strategies to enhance the healing of fractures continues to evolve with the introduction of both locally and systemically delivered compounds. The recent refinement in the use of autologous bone marrow as a bone graft material has brought the field of stem cell biology into orthopaedic practice. New recombinant peptides such as platelet- derived growth factor and teriparatide show promise as local and systemic enhancers respectively. Finally, recent evidence that mutations in elements of the Wnt signalling pathway lead to gain-of-function mutations in bone formation in rare clinical settings has provided the basis for the targeting of this pathway for the development of therapeutic agents for bone repair. These recent developments are presented as the "little secrets" of present day bone healing.