We would like to thank the commentators for their interest in our recent publication “Effects of botulinum toxin A on fracture healing” [1]. Despite thousands of previous studies, fracture healing is one of the most interesting hallmarks of orthopedics. Fracture healing occurs as a result of complex cellular and biochemical processes in which the periosteum, surrounding soft tissues, and medulla play an active role, in addition to bony tissue [2–4]. Basically, we all agree that the beneficial effects of botulinum toxin A in fracture healing can be explained by a paralytic immobilization effect, which may contribute to non-rigid fixation, and many studies have been presented in many papers concerning the effects of the botulinum toxin A on surrounding tissue. However, it is important to study botulinum toxin in order to identify the pros and cons of its use, and especially its effects on surrounding tissue, using bioassays.

Regarding the dosage of botulinum toxin A, we did not perform a pilot study with different dosages before we saw the interesting results of this study, but we are planning to use a new animal model in a study of the effects of different dosages with different fracture models.