Biologically Active Biomaterials in Delayed Fracture Repair: Mechanisms, Clinical Integration, and Prognostic Considerations
DOI:
https://doi.org/10.64784/085Keywords:
Delayed bone healing, bioactive biomaterials, bone regeneration, trauma surgery, bioactive glass, calcium phosphate, scaffold design, orthopedic traumatologyAbstract
Delayed bone healing remains a significant challenge in traumatology, particularly in complex fractures and biologically compromised environments where conventional fixation alone may be insufficient to achieve timely consolidation. In recent decades, bioactive biomaterials have emerged as relevant adjuncts in orthopedic trauma, offering not only structural support but also biological modulation of the fracture microenvironment. This review aims to synthesize current evidence on the clinical applications of bioactive biomaterials in delayed bone healing, focusing on their biological mechanisms, material design principles, and prognostic implications. A structured narrative review was conducted using peer-reviewed literature addressing bioactive glasses, calcium orthophosphate ceramics and cements, composite scaffolds, and injectable biomaterials. The results indicate that bioactive glass and composite scaffold strategies are frequently associated with favorable healing profiles, while calcium phosphate systems remain widely utilized due to their established clinical reliability and versatility. Injectable biomaterials demonstrate procedural advantages but show greater variability in outcomes, reflecting formulation and indication heterogeneity. Across all material classes, mechanical stability and infection control emerge as the most influential prognostic factors, underscoring that biomaterials function optimally as biological enhancers rather than substitutes for sound trauma principles. Overall, bioactive biomaterials represent a valuable component of contemporary fracture management when selected according to defect characteristics, biological conditions, and clinical context. This review provides an educational framework to support evidence-based decision-making in delayed bone healing, with relevance to trauma care settings in Latin America and beyond.
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