<p>Bone fractures pose a substantial medical burden in the population. Despite advancements in surgical techniques, internal fixation methods, and our comprehension of biologics, fracture healing experiences delays or impairment in as much as 4% of all fractures. Complications arising from impaired fracture healing pose therapeutic challenges for orthopedic surgeons and frequently result in chronic functional and psychological disabilities for patients. Consequently, there is a clinical imperative to enhance mechanical fixation with biologic strategies to expedite the process of osteogenesis. The identification of bone morphogenetic protein (BMP) has been a crucial milestone in comprehending the biology of fracture healing, sparking intensive clinical research as an adjunct to fracture treatment. Numerous in vitro and in vivo studies in animals have shed light on the intricate biologic interactions between BMPs and cellular receptors. These studies have compellingly demonstrated that recombinant human BMP-2 (rhBMP-2) stands out as a safe and effective treatment option for augmenting bone healing. Human clinical trials have yielded valuable insights into the optimal dosage, time course, carriers, and effectiveness of BMP-2 in the healing of tibial defects. The encouraging outcomes from these trials inspire optimism that a new frontier in biologic technology has emerged, offering a promising adjunct for the treatment of skeletal injuries and conditions. These advancements signify a potential paradigm shift in the approach to managing fractures and underscore the potential transformative impact of biologic interventions in the realm of skeletal health.</p>