English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Background: Bone is a dynamic tissue and undergoes anabolic and catabolic turnover through action of basic multicellular units of osteoblasts and osteoclasts known as bone metabolic units. Bone-specific alkaline phosphatase (BAP) is a specific marker of osteoblasts and gives a measure of bone forming activity. The tibial fracture is a good model for studying fracture healing in clinical setting because of its frequency of presentation. Methodology: A study to evaluate the changes in BAP levels during healing of isolated closed tibial shaft fracture was conducted by including 25 healthy adults of age 18 to 45 years. Normal fracture healing time was defined to be 6 months in a tibial shaft fracture. The patients having any systemic condition, disease, and/or drug intake affecting bone turnover were excluded. All the fractures were treated with closed reduction. Follow up was done at every 4 weeks till 6 months of injury to look for clinic-radiological signs of fracture union. Biochemical monitoring was done at time of injury, 4, 8 and 12 weeks. BAP was measured using enzyme immunoassay. Observation: All the fractures united. The baseline value of BAP was 16.9±6.94 U/L and it increased by 40.8% at 4 weeks (p=0.005), by 71% at 8 weeks (p=0.001) and 93.2% by 12 weeks. BAP and ALP were significantly increased from baseline (p = 0.005 and p = 0.001) in the 21 patients with sticky fracture site as compared to slightly decreased levels in the remaining 4 cases demonstrating mobility in both planes at 4 weeks. BAP and ALP levels at 8 weeks are significantly higher in the 10 patients having visible callus at 8 weeks as compared to the 15 patients having no callus visible at 8 weeks (p=0.041 & p=0.031). Conclusions: The rise of the marker paralleled the clinic-radiological signs of fracture healing such as absence of mobility at the fracture site and appearance of callus at fracture site at 8 weeks. The bone turnover markers are suggested as a non-invasive aid for monitoring fracture healing complementing the clinic-radiological evaluation.

Role of bone turnover marker-bone specific alkaline phosphatase evaluation in monitoring healing of tibial shaft fractures managed by closed reduction