Multiple roles of tumor necrosis factor-alpha in fracture healing

This review presents a summary of basic science evidence examining the influence of tumor necrosis factor-alpha (TNF-alpha) on secondary fracture healing. Multiple studies suggest that TNF-alpha, in combination with the host reservoir of pen-fracture mesenchymal stem cells, is a main determinant in the success of bone healing. Disease states associated with poor bone healing commonly have inappropriate TNF-alpha responses, which likely contributes to the higher incidence of delayed and nonunions in these patient populations. Appreciation of TNF-alpha in fracture healing may lead to new therapies to augment recovery and reduce the incidence of complications. (C) 2015 Elsevier Inc. All rights reserved.