Bone Healing and Hormonal Bioassay in Patients with Long Bone Fractures and Concomitant Spinal Cord Injury

Abstract

To ensure the possible accelerated osteogenesis of long bone fractures in patients with concomitant spinal cord injury and to investigate the mechanism causing it with the understanding of a possible neuro-hormonal cause, a hormonal bioassay of the blood of 21 of these patients was measured in the prospective controlled study and compared to 20 patients with only spinal cord injuries, 30 patients with only long bone fractures, and 30 healthy volunteers. 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 showed statistically significant higher levels of parathyroid hormone and growth hormone (p<0.005) and normal corticosteroids levels. Patients with long bone fractures only showed consistent and statistically significant higher level of noradrenaline and adrenaline hormones compared to patients with spinal cord injury alone or associated with long bone fractures (p<0.001). Leptin hormone shows statistically significant consistent decrease in patients with spinal cord injury and concomitant long bone fractures compared to healthy subjects (p<0.001). We believe, according to the results of this study that bone healing is accelerated in long bone fractures in patients with associated spine fractures and spinal cord injuries. We also can conclude that bone healing has a central neuronal control and a combined neuro- hormonal mechanism with a relative inhibition of the sympathetic nervous system is a possible cause of accelerated healing of long bone fractures in patients with associated spinal cord injury.