Although there are numerous methods for defining fracture-healing in
clinical studies, no consensus exists regarding the most valid and reliable
manner for assessing union or for determining which outcomes are most
important. This article summarizes and describes methods for the clinical
assessment of fracture-healing and reports results from a systematic review of
prevalent definitions currently used in published clinical studies.
Conventional radiography and ad hoc clinical definitions continue to be the
most commonly used means of assessing fracture-healing in clinical studies.
Investigators must improve upon and apply more rigorous outcome assessment in
clinical trials, emphasize patient-important outcomes, and report factors that
may bias estimated effects.