gms | German Medical Science

67. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie
89. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie
44. Tagung des Berufsverbandes der Fachärzte für Orthopädie

11. bis 16.11.2003, Messe/ICC Berlin

Changes of Biochemical Markers during the Fracture Healing in Osteoporosis.

Meeting Abstract (DGU 2003)

  • corresponding author Michael Pausch - Klinik und Poliklinik für Unfallchirurgie, Justus-Liebig Universität Giessen, Rudolf-Buchheim-Strasse 7, 35385, Giessen, Phone: 0641-9944601, Fax: 0641-9944609
  • C. Heiss - Department of Trauma Surgery, Justus-Liebig-University of Giessen, Germany
  • U. Wehr - Institut für Physiologie, Physiologische Chemie und Tierernährung
  • W. Rambeck - Institut für Physiologie, Physiologische Chemie und Tierernährung
  • R. Schnettler - Department of Trauma Surgery, Justus-Liebig-University of Giessen, Germany

Deutsche Gesellschaft für Unfallchirurgie. Deutsche Gesellschaft für Orthopädie und orthopädische Chirurgie. Berufsverband der Fachärzte für Orthopädie. 67. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 89. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie und 44. Tagung des Berufsverbandes der Fachärzte für Orthopädie. Berlin, 11.-16.11.2003. Düsseldorf, Köln: German Medical Science; 2003. Doc03dguF3-9

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgu2003/03dgu0443.shtml

Published: November 11, 2003

© 2003 Pausch et al.
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Outline

Text

Introduction

The aim of this experimental study was to evaluate the changes of biochemical markers during the fracture healing of distal radius fractures in premenopausal patients and postmenopausal patients with osteoporosis.

Materials and Methods

The study included 9 pre- (36±6.5 years) and 35 postmenopausal patients (68,5±7.4 years) with a fracture of the distal radius, although 10 pre- (34.3±3 years) and 19 postmenopausal women (64.4±7.2 years) without a fracture were admitted to this study. By means of quantitative computed tomography of the lumbar spine, we distinguished a non-osteoporotic postmenopausal group (T-score ≥d -2.5) and an osteoporotic postmenopausal group with a T-score below -2.5. All patients with a distal radius fracture were divided by the method of therapy (conservative / operative). Blood and urine samples were obtained at the time of admission. Thereafter, samples were collected 2, 4, 10 and 14 days after the injury, in 6 patients samples were collected over 6 weeks. The following biochemical bone markers were measured:

Serum: Crea, Ca, P, ALP, bALP, PICP, OC, ucOC, Vit. K, BSP

Urine: Crea, Ca, P, PYD, DPD, NTx

Results

In groups without a fracture (control group), the concentrations of biochemical markers were significantly lower than in groups during the osteoporotic and non-porotic fracture healing. The comparison of the pre- and postmenopausal fracture healing revealed less differences of concentration. The postmenopausal patients exhibited higher concentrations of activity. During the changes of the osteoporotic and non-porotic fracture healing significant differences were recognized. Bone resorption markers (PYD, DPD, NTx) of the premenopausal and postmenopausal non-porotic group started to increase in the first 4 days and returned to intial vales at the 5th day post fractionem. Bone formation markers (ALP, bALP, PICP, OC, ucOC) started to increase slowly during the fracture healing and showed significant differences of concentration between the bone healing in osteoporotic and non-porotic bone, also between the bone healing in young and postmenopausal patients. A significant increase of bone formation markers was noticed in the non-osteoporotic group.

Conclusion

In conclusion, biochemical formation and resorption markers reflected the bone remodelling process during the osteoporotic and non-porotic fracture healing. They changed differently depending upon the fracture and the bone mineral density. In osteoporotic bone no significant differences of concentration of bone formation and resorption markers could observed compared to the healing process of non-osteoporotic bone and the healing process of bone in young human beings.