The relation between Botulinum toxin-A and fracture healing. Comment on Hao et al.: Short-term muscle atrophy caused by Botulinum toxin-A local injection impairs fracture healing in the rat femur

摘要

We read with great interest the article by Hao et al. We congratulate them for their excellent study. Despite thousands of previous studies, fracture healing is one of the most interesting hallmarks at orthopedics. Fracture healing occurs as a result of complex cellular and biochemical processes in which the periosteum, surrounding soft tissues, and medulla play an active role in addition to bony tissue. Hao et al. aimed to investigate whether local muscle atrophy and dysfunction affect fracture healing in a rat femur fracture model by using Botulinum toxin-A (BTX-A). They concluded that; biomechanical testing indicated that the femurs of the BTX-A-treated side exhibited inferior mechanical properties compared with the control side. The inferior outcome following BTX-A injection, compared with saline injection, in terms of callus resistance may be the consequence of unexpected load and mechanical unsteadiness caused by muscle atrophy and dysfunction.