This Article Full Text Full Text (PDF) CME: Take the activities for this article: CME 1: January, February, March 2009 (publication date April 3, 2009; expir... Trauma Test 25: Spring 2009 (publication date May 15, 2009; expiration date... [Supplementary Material] Letters to the Editor: Submit a response Alert me when this article is cited Alert me when Letters to the Editor are posted Alert me if a correction is posted Services E-mail this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Rights and Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Cadosch, D. Articles by Zellweger, R. Search for Related Content PubMed Articles by Cadosch, D. Articles by Zellweger, R. Related Collections Adult Trauma Social Bookmarking                   What's this?

Humoral Factors Enhance Fracture-Healing and Callus Formation in Patients with Traumatic Brain Injury

¹ School of Anatomy and Human Biology, The University of Western Australia, 35 Stirling Highway, Crawley 6009, Western Australia, Australia. E-mail address for D. Cadosch: dcadosch{at}anhb.uwa.edu.au
² Departments of Diagnostic and Interventional Radiology (S.S.) and Orthopaedic and Trauma Surgery (A.P.S. and R.Z.), Royal Perth Hospital, Wellington Street, GPO Box X2213, Perth 6001, Western Australia, Australia

Investigation performed at Royal Perth Hospital, Perth, Western Australia, Australia

Disclosure: In support of their research for or preparation of this work, one or more of the authors received, in any one year, outside funding or grants in excess of $10,000 from SUVA Foundation (Swiss Workers Compensation Insurance). Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

Methods: Patients with a long-bone fracture and a traumatic brain injury (seventeen patients) or without a brain injury (twenty-four patients) were recruited. The Glasgow Coma Scale score was determined on admission. Radiographs of the fracture were made before surgery, at six weeks, and at three, six, and twelve months after surgery. The time to union was estimated clinically and radiographically, and the callus ratio to shaft diameter was calculated. Serum samples were collected at six, twenty-four, seventy-two, and 168 hours after injury, and their osteogenic potential was determined by measurement of the in vitro proliferation rate of the human fetal osteoblastic cell line hFOB1.19.

Results: Patients with a traumatic brain injury had a twofold shorter time to union (p = 0.01), a 37% to 50% increased callus ratio (p < 0.01), and their sera induced a higher proliferation rate in hFOB cells (p < 0.05). A linear relationship was revealed between hFOB cell proliferation rates and the amount of callus formed (p < 0.05). The Glasgow Coma Scale score was correlated with the callus ratio on both radiographic projections (p < 0.05), time to union (p = 0.04), and the proliferation rate of hFOB cells at six hours after injury (p = 0.03).

Conclusions: Patients with a severe brain injury release unknown humoral factors into the blood circulation that enhance and accelerate fracture-healing.

CiteULike    Connotea    Del.icio.us    Facebook    Technorati    Twitter    What's this?

Stanford University Libraries' HighWire Press (TM) assists in the publication of JBJS Online.
Copyright © 2009 by The Journal of Bone and Joint Surgery, Inc. Online ISSN: 1535-1386.
The Journal of Bone and Joint Surgery®, JBJS®, JB&JS®, and eJBJS® are registered in the U.S. Patent and Trademark Office.