title: Growth factors and cytokines in patients with long bone fractures and associated spinal cord injury.
abstract: BACKGROUND
  The aim of the study was to test the effect of acute traumatic spinal cord injury of quadriplegia or paraplegia on bone healing in patients with associated long bone fractures and to investigate the molecular and cellular events of the underlying mechanism for a possible acceleration.
  
  
  METHODS
  Healing indicators of long bone fractures and growth factors, IGF-II, platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), Activin-A, and cytokine I-L-1, in the patients' blood were calculated and measured for 21 patients with spinal cord injuries and associated long bone fractures in prospective controlled study and compared to 20 patients with only spinal cord injuries, 30 patients with only long bone fractures, and 30 healthy volunteers.
  
  
  RESULTS
  The study results showed that long bone fractures in patients with associated acute traumatic spinal cord injury of quadriplegia or paraplegia heal more expectedly, faster, and with exuberant florid union callus (P > 0.001) and show statistically significant higher levels of growth factors like PDGF, VEGF, Activin-A, and cytokine I-L-1, along the 3 weeks of follow-up (P > 0.005). I-IGF-II showed statistically significant subnormal level along the whole follow-up period in the same patients (P > 0.005).
  
  
  CONCLUSIONS
  We concluded that long bone fractures in spinal cord injury patients heal more expectedly, faster, and with exuberant and florid callus formation; growth factors like IGF-II, PDGF, VEGF, Activin-A, and cytokine I-L-I have roles as mediators, in molecular events and as byproducts of the subtle mechanism of accelerated osteogenesis in these patients and may represent therapeutic potentials to serve as agents to enhance bone repair.
authors.affiliation: Department of Orthopaedic Surgery, Jahra Hospital, 01753 Alsafat, Al-Jahra Health District, Kuwait.
authors.forename: Fathy G
authors.initials: FG
authors.lastname: Khallaf
authors.affiliation: Department of Surgery, Faculty of Medicine, Kuwait University, Safat 13060, Kuwait.
authors.forename: Elijah O
authors.initials: EO
authors.lastname: Kehinde
authors.affiliation: Department of Orthopaedic Surgery, Jahra Hospital, 01753 Alsafat, Al-Jahra Health District, Kuwait.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Mostafa
keywords: Accelerated bone healing; Cytokines; Growth factors; Long bone fractures; Spinal cord injuries