title: The effects of spinal cord injury on bone healing in patients with femoral fractures.
abstract: BACKGROUND
  Orthopedic literature states that fractures of long bones, when associated with traumatic brain injuries, frequently heal with excessive callus and faster than normal. Few studies, however, have reported these phenomena being induced by spinal cord injury (SCI). Our objective is to compare the extent of callus and the rate of healing of long-bone fractures in patients with or without SCI. Subgroup comparisons were performed among the patients with SCI in terms of different levels of SCI.
  
  
  METHODS
  The final mean volume of callus formation and the rate of union of nailed fractures of the femur were determined radiologically in 22 femoral fracture patients with SCI (seven cervical, six thoracic, and nine lumbar spine injury) and compared with those in a group of 22 patients with similar types of fractures but without SCI.
  
  
  RESULTS
  The final mean callus volume in the fracture/SCI group was significantly higher than the fracture-only group (P < 0.001). The fractures in the fracture/SCI group united in an average time of 22.86 weeks compared with 25.04 weeks in the fracture-only group (P < 0.05). We observed 84.6% (11 of 13) of patients with cervical and thoracic SCI patients with accelerated fracture healing (cervical 6 of 7, thoracic 5 of 6), but only 44.4% (4 of 9) of patients with lumbar SCI appeared to show this phenomenon (P < 0.05).
  
  
  CONCLUSIONS
  These results confirm that SCI may be associated with accelerated fracture healing and enhanced callus formation. Furthermore, our study revealed a trend toward enhanced osteogenesis in cervical or thoracic SCI compared with lumbar SCI.
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.forename: Xiang
authors.initials: X
authors.lastname: Yao
authors.forename: Li
authors.initials: L
authors.lastname: Xiao
authors.forename: Xingguo
authors.initials: X
authors.lastname: Tang
authors.forename: Hua
authors.initials: H
authors.lastname: Ding
authors.forename: Hongxi
authors.initials: H
authors.lastname: Zhang
authors.forename: Jishan
authors.initials: J
authors.lastname: Yuan
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002146:Bony Callus / Q000473:pathology*; D015331:Cohort Studies; D005260:Female; D005264:Femoral Fractures / Q000150:complications*; D017102:Fracture Healing / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013119:Spinal Cord Injuries / Q000150:complications*
keywords: Bone healing; Callus; Femoral fracture; Spinal cord injury