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General information about fracture healing
Fracture incidents were estimated at approximately 3,490,000 in the EU in 2010 for people above 50 years of age. This number of comprises approximately 620,000 hip fractures, 520,000 vertebral fractures, 560,000 forearm fractures and 1,800,000 other fractures. The demographic projection in the European Union for the upcoming years foresee an increase in the number of fractures, as age is an important risk factor for their occurence and the elderly population is projected to increase. In the European Union, the population over 50 years is expected to increase by approximately 20% in the next 10 years. In numbers this means that from 183 million in 2010 the population over 50 will increase to 219 million in 2025. Among these the population over 80 will see the highest increase of up to 32%. The annual number of fractures in the EU will rise from 3.5 million in 2010 to 4.5 million in 2025. Therefore the research into understanding the bone healing process and developing therapeutic approaches to enhance bone healing especially in elderly patients is still a very valid research areal. (Estimates are based on the UN World Population Projections using the medium variant.)
Interconnectivity between the immune and skeletal system
The bone marrow is the place where cells of both systems, the immune and the bone system, develop: osteoblasts, osteoclasts, granulocytes, monocytes, macrophages, natural killer cells, dendritic cells and lymphocytes. Dependent on certain stimuli, myeloid precursor cells can differentiate into either macrophages or osteoclasts: Both are phagocytic cells of the immune and bone system, respectively. Osteoclasts are responsible for the resorption of bony material. The growing importance of analysis of the impact of the immune system during bone homeostasis and bone regeneration led to the introduction of the research field “osteoimmunology” at the beginning of 21th century.