Changes in biochemical markers after lower limb fractures
Karl Stoffel, Hanna Engler, Markus Kuster & Walter Riesen
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abstract
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BACKGROUND: The bone remodeling sequence after bone fracture changes
the concentrations of biochemical bone markers, but the
relationships of fracture size and of healing time to changes in
biomarkers are unclear. The present pilot study was undertaken to
determine the changes found in serum bone markers after plate
osteosynthesis of closed distal tibial and malleolar fractures
during a study period of 24 weeks. METHODS: We measured
tatrate-resistant acid phosphatase (TRACP 5b), collagen type I
C-terminal telopeptide (ICTP), bone-specific alkaline phosphatase
(bone ALP), osteocalcin (OC), procollagen type I C-terminal
propeptide (PICP), procollagen type III N-terminal propeptide
(PIIINP), and human cartilage glycoprotein 39 (YKL-40) in 20
patients with lower limb fractures (10 malleolar, 10 tibia). A
physical examination and radiographs were completed to assess
evidence of union. RESULTS: All malleolar fractures healed within 6
weeks, whereas 2 tibial fractures did not show complete bone healing
after 24 weeks. Changes were comparable but more pronounced in the
tibia group, and marker concentrations remained increased at the end
of study (bone ALP, 86 vs 74 U/L; OC, 14.9 vs 7.7 microg/L; ICTP:
5.6 vs 3.3 microg/L at day 84 after osteosynthesis, P <0.05 in
tibia; 80 vs 70 U/L, 8 vs 5.2 microg/L, and 3.5 vs 3.2 microg/L,
respectively, in the malleolar fracture group). CONCLUSIONS: In
normal bone healing, changes in bone turnover markers were primarily
dependent on the fracture size. Delayed tibia fracture healing may
involve a disturbance in bone remodeling.
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citation
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Stoffel K, Engler H, kuster m, Riesen W. Changes in biochemical
markers after lower limb fractures. Clinical chemistry 2007;
53:131-4.
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type
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journal paper/review (English)
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date of publishing
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1-2007
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journal title
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Clinical chemistry (53/1)
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ISSN print
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0009-9147
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pages
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131-4
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PubMed
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17130179
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DOI
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10.1373/clinchem.2006.076976
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