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Joint German Congress of Orthopaedics and Trauma Surgery

02. - 06.10.2006, Berlin

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Beta-Cross Laps are decreased in patients with delayed fracture healing

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  • P. Bauer - BG-Unfallklinik Ludwigshafen Unfallchirurgie, Universität Heidelberg, Ludwigshafen, Germany
  • P. Roth - Endokrinologie, Labor Limbach, Heidelberg, Germany
  • A. Moghaddam - BG-Unfallklinik Ludwigshafen Unfallchirurgie, Universität Heidelberg, Ludwigshafen, Germany
  • A. Wentzensen - BG-Unfallklinik Ludwigshafen Unfallchirurgie, Universität Heidelberg, Ludwigshafen, Germany
  • S. Weiss - Orthopädische Klinik Heidelberg-Schlierbach, Universität Heidelberg, Heidelberg, Germany
  • G. Zimmermann - BG-Unfallklinik Ludwigshafen Unfallchirurgie, Universität Heidelberg, Ludwigshafen, Germany

Deutscher Kongress für Orthopädie und Unfallchirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 92. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie und 47. Tagung des Berufsverbandes der Fachärzte für Orthopädie. Berlin, 02.-06.10.2006. Düsseldorf, Köln: German Medical Science; 2006. DocE.4.1-1716

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgu2006/06dgu0102.shtml

Published: September 28, 2006

© 2006 Bauer et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Background: In previous studies we could show, that some osteoanabolic cytokines are showing a significant systemic increase while fracture healing in the first two weeks. Patients with delayed fracture healing have constantly lower serum levels or are completely missing that increase. Beta-cross laps are osteocatabolic markers. The purpose of this study was to determine any different temporal expression patterns of this peptide in patients with normal and delayed fracture healing.

Method: From patients with either normal (group 1) or delayed fracture healing (group 2) and from patients with non-healing fractures serum samples were collected 1,2,4,8 and 12 weeks after the fracture, and again after 1 year; the latter serving as baseline values. To minimize interindividuell differences in serum levels of patients there were included 15 patients in each group matched for age, sex, fracture localisation and fixation. Criteria for exclusion were al comorbiditis known to increase the physiological serum levels of beta-cross laps. The blood samples were collected between in the morning after overnight fasting.

Results: Patients with normal fracture healing showed a significant increase of beta-cross laps serum levels until the fourth week after fracture in absolute and relative values (160% in the fourth week). The baseline level was determined one year after definitive fracture healing. Up to the 12th week the levels decreased and remained constantly at the baseline level. Patients with delayed fracture healing revealed a significant different time course. In contrast to the normal healing fractures serum levels showed a decrease in the first week after trauma (p=0,016). In the second week the serum levels increased rapidly and reached the same values as patients with normal fracture healing.

Conclusion: As expected patients with normal fracture healingare showing increasing levels of osteoanabolic and osteocatabolic markers, reflecting the higher turnover of the healing tissue. As we could show in former studies that the physiological answer of osteoanabolic cytokines is reduced in patients with delayed fracture healing, so it is obviously with osteocatabolic markers like beta-cross laps also. Nevertheless beta-cross laps may be used in future for early diagnosis of delayed fracture healing.