Fracture-healing is regulated in part by mechanical factors. Study of the
processes by which the mechanical environment of a fracture modulates healing
can yield new strategies for the treatment of bone injuries. This article
focuses on several key unanswered questions in the study of
mechanotransduction and fracture repair. These questions concern identifying
the mechanical stimuli that promote bone-healing, defining the mechanisms that
are involved in this process, and examining the potential for cross-talk
between investigations of mechanotransduction in bone-healing and in healing
of other mesenchymally derived tissues. Several approaches to obtain accurate
estimates of the mechanical stimuli present within a fracture callus are
proposed, and our current understanding of the mechanotransduction processes
involved in bone-healing is reviewed. Further study of mechanotransduction
mechanisms is needed in order to identify those that are most critical and
active during the various phases of fracture repair. A better understanding of
the effect of mechanical factors on bone-healing will also benefit the study
of healing, regeneration, and engineering of other skeletal tissues.