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Inflammatory cells in normal human fracture healing.

We studied inflammatory cells in specimens of callus taken from normally healing human fractures. Using immunohistochemistry, T-cells, B-cells, macrophages, HLA-DR expression and endothelial proliferation were assessed. Macrophages were present from an early stage but became less numerous later. T-cells were initially specifically recruited into the fracture site at the stage of granulation tissue, but subsequently excluded from areas of bone and cartilage formation. Inflammatory cells may control and coordinate fracture healing as has been proposed for soft tissue wound healing. The most likely mechanism for this is by the cytokines and growth factors which they are known to release.