Observational studyEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2019
Prognostic potential of markers of bone turnover in delayed-healing tibial diaphyseal fractures.
Observational study in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 19 citations in OpenAlex.
- Association between bone turnover markers and alveolar socket healing rate: A cross-sectional study.Oral and maxillofacial surgery · 2025Article
- Functional mechanism and clinical implications of miR-455-5p in delayed fracture healing.Journal of orthopaedic surgery and research · 2025Article
- Efficacy of biomarkers in the endochondral phase of fracture repair and healing in long bones: A clinical observational studys.PLoS medicine · 2025Observational
- Arthroscopic versus open fixation for medial malleolus fractures improves trauma response and bone healing.Scientific reports · 2025Article
- The Genetic and Biological Basis of Pseudoarthrosis in Fractures: Current Understanding and Future Directions.Diseases (Basel, Switzerland) · 2025Review
- Association between Bone Turnover Markers and Fracture Healing in Long Bone Non-Union: A Systematic Review.Journal of clinical medicine · 2024Review
- Bone Regenerate Evaluation Methods.Revista brasileira de ortopedia · 2024Article
- The progress in quantitative evaluation of callus during distraction osteogenesis.BMC musculoskeletal disorders · 2022Review
- Bone turnover markers as surrogates of fracture healing after intramedullary fixation of tibia and femur fractures.Bone & joint research · 2022Article
- Efficacy of romosozumab in patients with osteoporosis on maintenance hemodialysis in Japan; an observational study.Journal of bone and mineral metabolism · 2021Observational
- Focus on non-union of fractures.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2019Article
- Clinical Utility of Biochemical Marker of Bone Turnover: Fracture Risk Prediction and Bone Healing.Journal of bone metabolism · 2018Review
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionClinical and radiographic examinations detect delayed or nonunion only after the event has occurred. Biochemical markers of bone turnover (BTMs) are promising laboratory tools that offer an early insight into the likelihood of delayed union. We hypothesized that BTMs display temporal variations following fractures and the behavior of BTMs differ between normal and delayed union of fractures.
methodsThis was a prospective study of patients with closed fracture of tibia treated with intramedullary, interlocking nailing. BTM assays (NTX, BSAP, P1NP and osteocalcin) and clinical and radiographic assessments were obtained preoperatively and postoperatively at 8,12, 24, 36 and 72 weeks. Temporal trend of elevation of serum levels of BTMs post-fracture was the primary assessment criterion and radiographic and clinical assessment of fracture union were the secondary assessment criteria.
resultsThe average time for fracture union was 15.24 weeks (range 15-19 weeks). The values of both bone formation and resorption markers peaked at the eighth week following the fracture. Resorption markers returned to baseline by 36 weeks. Among the formation markers, BSAP levels showed the smallest increase and returned to baseline earlier (36 weeks) than P1NP and osteocalcin (72 weeks). P1NP showed the most dramatic change, increasing to 2.5 times the mean baseline level at 8 weeks in normal union of fractures. The levels of bone formation markers (BSAP, OC, PINP) were significantly lower in patients with delayed union. There was no significant difference in the levels of the resorption marker (NTX) between normal and delayed union patients.
conclusionSerial monitoring of biochemical markers of bone turnover can be used as an adjunct to clinical and radiological observations to predict delayed union LEVEL OF EVIDENCE: Level 2 (prospective observational study).
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