Investigation of Bony Scar Tissue (Callus) formation in proximal femoral fracture and its relation to therapeutic application of PTH (1-34)
Alireza Manafi Rasi, Mohammad Mahdi Omidian, Hasan Barati, Farzad Amuzade Omrani, Mohammad Sadegh Abbaszade, Mojtaba Baroutkoub
1656
ABSTRACTBackground: High Economic and social burdens of fracture complications have turned rapid recovery of fractures into a main objective for public health care. The role of parathyroid hormone (PTH) in osteoporosis treatment is generally accepted, but its effects on improving fractures remains controversial.Aim: To analyze the effects of parathyroid hormone analogs in the healing process of bone fractures in patients with proximal femoral fractures.Methods: This study is retrospective and was carried out via examination of hospital records of 40 patients who had proximal femoral fractures, and were hospitalized and treated in Kosar hospital, Iran during 2014-2015. Studied patients were divided into two groups each consisted of 20 members; the control group who only received normal treatment, and the experimental group who received normal treatment plus daily subcutaneous injections of the parathyroid hormone. Required data such as age, sex, area of fractures, underlying diseases, smoking history, the final condition of the fractured area, quality of callus formation after three months and a need for a reoperation were gathered. Afterwards, the role of demographic factors on final condition of the fractured area and the need for a reoperation were analyzed.Results: After the three-month follow-ups were completed, it became clear that compared to the control, use of the parathyroid hormone significantly increased the pace of bony scar tissue (callus) formation (P<0/001) in the experimental group and also although higher percent of the experimental group patients (85%) succeeded in forming a proper callus compared to the control (60%), but this difference is not statistically significant (p=0/077). Also, the percentage of patients in need of reoperation was higher in the control (36.8%) compared to the experimental group patients (15%), but this difference was not statistically significant (p=0/118) also. There was also a statistically significant difference between different age categories and the final condition of scar formation (P=0/036).Conclusion: The results of this study show that subcutaneous application of 20 mg per day of the parathyroid hormone can speed up the bony scar tissue formation and recovery of patients.Key words: PTH hormone, Fracture, Proximal femur, Bone, Callus formation
Background: High Economic and social burdens of fracture complications have turned rapid recovery of fractures into a main objective for public health care. The role of parathyroid hormone (PTH) in osteoporosis treatment is generally accepted, but its effects on improving fractures remains controversial.
Aim: To analyze the effects of parathyroid hormone analogs in the healing process of bone fractures in patients with proximal femoral fractures.
Methods: This study is retrospective and was carried out via examination of hospital records of 40 patients who had proximal femoral fractures, and were hospitalized and treated in Kosar hospital, Iran during 2014-2015. Studied patients were divided into two groups each consisted of 20 members; the control group who only received normal treatment, and the experimental group who received normal treatment plus daily subcutaneous injections of the parathyroid hormone. Required data such as age, sex, area of fractures, underlying diseases, smoking history, the final condition of the fractured area, quality of callus formation after three months and a need for a reoperation were gathered. Afterwards, the role of demographic factors on final condition of the fractured area and the need for a reoperation were analyzed.
Results: After the three-month follow-ups were completed, it became clear that compared to the control, use of the parathyroid hormone significantly increased the pace of bony scar tissue (callus) formation (P<0/001) in the experimental group and also although higher percent of the experimental group patients (85%) succeeded in forming a proper callus compared to the control (60%), but this difference is not statistically significant (p=0/077). Also, the percentage of patients in need of reoperation was higher in the control (36.8%) compared to the experimental group patients (15%), but this difference was not statistically significant (p=0/118) also. There was also a statistically significant difference between different age categories and the final condition of scar formation (P=0/036).
Conclusion: The results of this study show that subcutaneous application of 20 mg per day of the parathyroid hormone can speed up the bony scar tissue formation and recovery of patients.
Key words: PTH hormone, Fracture, Proximal femur, Bone, Callus formation