Bone-turnover markers in fracture healing

Cox, George E.; Einhorn, Thomas A.; Tzioupis, C.; Giannoudis, Peter V.

doi:10.1302/0301-620x.92b3.22787

Cited by 97 publications

(87 citation statements)

References 47 publications

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“…All of these serum markers increased or decreased after different skeletal bone fractures and fluctuated during fracture healing in agreement with the literature data (14,(24)(25)(26). For example, OC elevated at 24 weeks after fracture of the tibial shaft and rose at 1 week after distal radial fracture.…”

Section: Discussionsupporting

confidence: 90%

“…PYD-DPYD peaks 1 to 8 weeks after proximal femoral fracture, and PYD peaks 1 to 4 weeks after fracture of the tibial shaft. PYD is a less specific marker of bone resorption than DPYD since it is abundant in all connective tissues; however, DPYD is distributed generally in bone and dentin, and 90% of the bone matrix consists of type I collagen (14,26). In the present study, no significant changes were observed for the markers of bone formation and resorption analyzed between the groups.…”

Section: Discussioncontrasting

confidence: 69%

“…For example, OC elevated at 24 weeks after fracture of the tibial shaft and rose at 1 week after distal radial fracture. ALP increased at 4 weeks after fracture of the tibial shaft and remained elevated at 1 year (26). PYD-DPYD peaks 1 to 8 weeks after proximal femoral fracture, and PYD peaks 1 to 4 weeks after fracture of the tibial shaft.…”

Section: Discussionmentioning

confidence: 89%

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Ankaferd Blood Stopper: Does it have a role in fracture healing?

Aygül¹,

Topuz

Okay³

et al. 2013

Turk J Med Sci

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High-pressure and ultrahigh-pressure metamorphic rocks crop out widely in the northern Aegean. In many instances their ages and tectonic setting are poorly constrained. Here we report newly discovered high-pressure rocks of continental crustal origin and of Late Cretaceous age southwest of the Marmara Sea. Th ey occur at the contact between the Rhodope-Strandja Zone in the north and the Sakarya Zone in the south.Th e Kemer Metamorphic Complex is composed mainly of mica schist, calcschist and marble with minor metabasite and serpentinite. Th e mica schists contain garnet, phengite (3.30-3.44 c.p.f.u), (±) paragonite, albite, epidote, calcite, chlorite and titanite. Th e high-pressure metamorphic origin of the mica schists is shown by the high silica contents of the white micas and by glaucophane inclusions in garnet. In the metabasites the mineral assemblage is garnet, barroisite, epidote, albite, titanite, quartz, phengite and chlorite; no evidence is left for the former presence of high-pressure minerals. Metamorphic conditions are constrained by mineral equilibria: a 560-640°C temperature at a minimum pressure of 10 kbar. Th e metamorphism is dated at 64-84 Ma by the Rb-Sr phengite-whole rock method.Th e Kemer Metamorphic Complex is in tectonic contact with an accretionary ophiolitic mélange consisting of limestone, basalt, serpentinite, greywacke, radiolarian chert and metabasite. Some of the metabasites in the mélange contain Na-amphibole and lawsonite, indicating a subduction origin. Th e ages of the limestone blocks in the mélange range from Late Triassic to Late Cretaceous and that of the radiolarite blocks from Middle Jurassic to Early Cretaceous, indicating an oceanic domain dating back to Late Triassic at least. Th e Kemer Metamorphic Complex and the Çetmi Mélange are intruded by a granodiorite of Early Eocene (52 Ma) age and are unconformably covered by a Late Eocene volcano-sedimentary succession.Th e lithology of the Kemer Metamorphic Complex resembles a continental margin rather than an oceanic accretionary complex. Th is and the presence of a Late Cretaceous magmatic arc in the north (Sredna-Gora-Pontide) suggest that the Kemer metamorphic rocks were initially deposited on the northern passive margin of the Sakarya Zone, which was subducted under the Rhodope-Strandja continental domain.

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Section: Discussionsupporting

confidence: 90%

Section: Discussioncontrasting

confidence: 69%

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Ankaferd Blood Stopper: Does it have a role in fracture healing?

Aygül¹,

Topuz

Okay³

et al. 2013

Turk J Med Sci

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“…It also is important to point out that the baseline urine NTX and BALP levels were greater in the fracture group. A previous study showed that fracture healing increased bone marker responses [11]. Thus, it is possible that the pretreatment bone marker levels in the fracture group were already elevated to maximal or submaximal levels, contributing to smaller degrees of change in both bone markers during posttreatment followup.…”

Section: Discussionmentioning

confidence: 92%

A Fracture Does Not Adversely Affect Bone Mineral Density Responses after Teriparatide Treatment

Unnanuntana

Ton

Kleimeyer

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Fracture leads to local and systemic catabolic physiologic changes. As teriparatide is an agent used to treat osteoporosis in patients with fragility fractures, it is unclear whether teriparatide treatment alters bone mineral density (BMD) and bone markers when given to patients with fractures. Questions/purposes We asked whether BMD and bone marker responses would be blunted in patients with fractures placed on teriparatide after fracture compared with patients without fractures on teriparatide. Patients and MethodsWe retrospectively collected data from 141 patients treated with teriparatide for osteoporosis. Seventy-seven patients received teriparatide after fractures (fracture group), whereas 64 were treated for other indications (nonfracture group). We determined BMD at the lumbar spine and at the proximal femur before and 12 and 24 months posttreatment. Bone markers (urine N-telopeptide [urine NTX], bone-specific alkaline phosphatase [BALP]) were measured at baseline and 3, 12, and 24 months posttreatment. Results Mean lumbar spine and hip BMDs at last followup increased from baseline with no differences between groups to approximately 9% and 4% at 24 months, respectively. Both bone markers increased from baseline in the nonfracture group, peaking at 12 months. For the fracture group, only urine NTX increased at 3 and 12 months posttreatment. Although the peak levels of both bone markers in the nonfracture group were greater, there was no difference between the two groups. Conclusions Fracture does not have a negative effect on the BMD and bone marker responses to teriparatide treatment. Clinicians should anticipate comparable BMD responses when treating patients with teriparatide for osteoporotic fractures and for other indications. Level of Evidence Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

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“…Therapy with skeletal stem cells from bone marrow proved effective in osteogenic stimulation of fracture nonunion through a noninvasive method, by promoting bone union in patients who had a one-year or longer fracture and in whom several previous surgeries had failed (ZAMPROGNO, 2007). Cox et al (2010) studied bone markers in fracture consolidation, and concluded that the available evidence does not support the routine use of these markers to evaluate fracture healing, and the ability to measure interventions for accelerating fracture consolidation has not been established.…”

Section: Treatmentmentioning

confidence: 99%

Nonunion fractures in small animals - A literature review

Santos

Ferrigno

Dal‐Bó

et al. 2016

SCA

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Bone nonunion is observed when the healing of a fracture fails and all processes of biologic repair cease. It is a frequent complication during fracture treatment in small animals. Nonunions are classified as viable or nonviable, and most cases result from technical error (e.g., inadequate or inappropriate choice of the type of stabilization), poor vascularization, excessive distance between the fragments, infection, and systemic disease, or local as well as idiopathic factors. The diagnosis is made when there is no radiographic evidence of bone healing. This condition cannot be treated conservatively; rather, nonunions require surgical intervention involving removal of implants (besides exuberant callus removal), proper alignment, and compression of the fracture site. As bone nonunion remains a common problem in clinical practice, the objective of this paper is to review the pathophysiology and methods for treating of the condition. Key words: Fracture. Nonunion. Radius and ulna. Dogs. ResumoA não união óssea acontece quando ocorre falha na consolidação óssea de uma fratura, onde todos os sinais de reparação aparentemente cessaram. É uma freqüente complicação do tratamento de fraturas em pequenos animais. As não uniões são classificadas em viáveis e não-viáveis e podem resultar de diversos fatores como estabilização inadequada, vascularização deficiente, distância excessiva entre os fragmentos, infecção, doença sistêmica ou local e fatores idiopáticos. A maior parte das não uniões resulta de escolha inadequada da forma de estabilização ou falha técnica por parte dos cirurgiões. O diagnóstico é quando radiograficamente não existem sinais de evolução da consolidação óssea. Esta afecção não pode ser tratada de forma conservadora, o tratamento é cirúrgico e é mandatória remoção dos implantes que falharam, remoção do calo exuberante, alinhamento adequado e compressão do foco de fratura. O objetivo deste trabalho é revisar a fisiopatologia, assim como as formas de tratamento desta afecção tão comum na prática clínica. Palavras-chave: Fratura. Não união. Rádio e ulna. Cães.

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Bone-turnover markers in fracture healing

Cited by 97 publications

References 47 publications

Ankaferd Blood Stopper: Does it have a role in fracture healing?

Ankaferd Blood Stopper: Does it have a role in fracture healing?

A Fracture Does Not Adversely Affect Bone Mineral Density Responses after Teriparatide Treatment

Nonunion fractures in small animals - A literature review

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