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Neuroinflammatory regulation of fracture healing after traumatic brain injury: Clinical evidence and emerging mechanistic insights
Xi Chen, Shou-Xiang Kuang, Cheng-Gui Zhang, Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250000, Shandong Province, China
Feng-Ge Zhou, Tumor Research and Therapy Center, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250000, Shandong Province, China
Author contributions: Chen X contributed to the conceptual development of the manuscript and drafted the initial version; Kuang SX contributed to refining the discussion of key clinical challenges; Zhou FG provided interdisciplinary expertise that helped shape the perspective of the manuscript; Zhang CG conceived the central perspective and overall framework of this opinion review and supervised the writing and revision process; and all authors have read and approved the final manuscript.
AI contribution statement: ChatGPT (OpenAI, GPT-4) was used during manuscript and answering-reviewers document preparation. ChatGPT (OpenAI, GPT-4) was used only to assist with literature search and language polishing. All content was verified by the authors. The manuscript’s writing, scientific content, and study design were independently completed by the authors. No AI-generated figures were used.
Supported by National Natural Science Foundation of China, No. 82202701; Natural Science Foundation of Shandong Province, China, No. ZR2022QH184; and Taishan Scholars Program.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Cheng-Gui Zhang, MD, PhD, Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 9677 Jingshi Road, Jinan 250000, Shandong Province, China. chenggui1214@pku.edu.cn
Received: February 24, 2026
Revised: April 18, 2026
Accepted: May 22, 2026
Published online: July 18, 2026
Processing time: 137 Days and 5.5 Hours
Revised: April 18, 2026
Accepted: May 22, 2026
Published online: July 18, 2026
Processing time: 137 Days and 5.5 Hours
Core Tip
Core Tip: Accelerated fracture healing associated with traumatic brain injury represents a distinct biological phenomenon that cannot be explained by single factor mechanisms. This paper proposes that an integrated regulatory network involving the nervous, immune, and endocrine systems underlies this process. By synthesizing clinical observations and experimental evidence, it highlights a system level framework and provides insight into the potential mechanisms of neuroendocrine and immune interactions in fracture repair.