title: Bone Healing and Hormonal Bioassay in Patients with Long-Bone Fractures and Concomitant Head Injury.
abstract: OBJECTIVE
  The aim of this study is to investigate healing of fractures in patients with concomitant head injuries and to measure blood hormone levels to elucidate the mechanism of a possible accelerated osteogenesis.
  
  
  METHODS
  One hundred and sixty-two patients were included in this study and divided into 3 cohorts: group A with head injuries only (n = 52); group B with head injuries as well as long-bone fractures (n = 50); group C with long-bone fractures only (n = 60). Fracture-healing parameters including time of appearance and thickness of the bridging callus, and blood hormonal assays were measured and compared using Student's t test.
  
  
  RESULTS
  The mean time to healing was significantly lower in cohort B (6.9 ± 2.9 weeks) than C (22.4 ± 8.7 weeks; p = 0.001). The mean thickness of the healing callus was significantly higher in cohort B (26.3 ± 9.7 mm) than C (8.1 ± 5.9 mm; p = 0.002). The mean healing rate was also higher in cohort B (4.5 ± 2.3 mm/week) than C (0.38 ± 0.21 mm/week; p = 0.001). Blood hormonal assays in group B showed higher values of parathyroid hormone and growth hormone than in group C. However, adrenaline and noradrenaline values were lower in group B than in group C at all measured time intervals, and correspondingly leptin was lower in all groups (p = 0.001). Corticosteroid values were normal in group B compared to slightly higher values in group C, also at all measured time intervals.
  
  
  CONCLUSIONS
  In this study, healing of fractures in patients with concomitant head injuries was accelerated, thereby indicating an involvement of a combined neurohormonal mechanism.
authors.affiliation: Department of Orthopaedic Surgery, Jahra Hospital, Kuwait, Kuwait.
authors.forename: Fathy G
authors.initials: FG
authors.lastname: Khallaf
authors.forename: Elijah O
authors.initials: EO
authors.lastname: Kehinde
authors.forename: Sundus
authors.initials: S
authors.lastname: Hussein
mesh_terms: D000305:Adrenal Cortex Hormones / Q000097:blood; D000328:Adult; D002146:Bony Callus / Q000503:physiopathology; D006259:Craniocerebral Trauma / Q000453:epidemiology* / Q000503:physiopathology*; D018483:Diaphyses / Q000503:physiopathology; D005260:Female; D017102:Fracture Healing / Q000502:physiology*; D050723:Fractures, Bone / Q000453:epidemiology* / Q000503:physiopathology*; D015600:Glasgow Coma Scale; D013006:Growth Hormone / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D010012:Osteogenesis / Q000502:physiology; D010281:Parathyroid Hormone / Q000032:analysis; D013997:Time Factors; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D010281:Parathyroid Hormone; D013006:Growth Hormone