Fracture repair in the elderly: Clinical and experimental considerations

•Fractures in the elderly represent a significant and rising socioeconomic problem. However, there are little direct clinical data describing the effects of aging on bone repair, which are complicated by effects from co-morbidities that would affect healing.•Basic research indicates that each of the components of fracture repair—cells, extracellular matrix, blood supply, and molecules and their receptors—are negatively impacted by aging, likely impacting healing.•Further study is necessary to delineate the effects of aging and new treatment strategies and technologies should address the multiple specific healing issues seen in elderly fracture patients.