ABSTRACT
BACKGROUND: Vascular endothelial growth factor (VEGF) is a multifunctional cytokine that promotes angiogenesis, improves vascular permeability, maintains vascular stability, and has positive effects on fracture healing and bone regeneration. VEGF-based treatment is expected to become an emerging means for accelerating fracture healing. OBJECTIVE: To explore the effects of VEGF on fracture healing and to review its influencing factors and clinical applications. METHODS: The CNKI and PubMed databases were searched for articles related to VEGF effect on fracture healing published from January 2014 to March 2019 with the key words of “vascular endothelial growth factor, fracture healing” in Chinese and English, respectively. Initially 167 articles were retrieved, and only 85 eligible articles were included in result analysis after removal of unrelated or duplicate literature. RESULTS AND CONCLUSION: VEGF exists in different cells of the fracture end, and the expression in different cells has significant periodicity. VEGF promotes angiogenesis, enhances vascular permeability, and maintains the normal morphology and integrity of blood vessels, thereby promoting fracture healing and bone regeneration. Several physicochemical factors and cytokines can change the expression of VEGF, thus influencing the fracture healing process. VEGF-based tissue engineering therapies have significant advantages, and the main methods include: delivering VEGF into the affected area using tissue engineering materials; maintaining and improving VEGF expression using gene transfection technology; combining VEGF with other cytokines and exogenous stem cells; and applying bio-coatings based on the upregulation of VEGF. With the interdisciplinary development, VEGF-based tissue engineering treatment is expected to be a hot topic in medical research.