Effect of calcitonin in the outcome of distal radial fractures in elderly patients

Abstract

Background: Distal radial fractures are common and produce significant morbidity in elderly osteoporotic individuals. Calcitonin prevents bone resorption in osteoporotic individuals and hence can reduce morbidity in the immediate post fracture period. But scientific evidence regarding its efficacy in improving pain and functional abilities is lacking. Hence this study is being done to assess the clinical and radiological parameters after calcitonin usage in immediate post fracture period. Methods: 50 elderly patients with distal radial fractures treated conservatively with plaster application were randomly divided into two groups. One group received 400 IU of nasal salmon calcitonin daily for 6 months and the other group did not receive it. Demographic data of patients, co-morbid illnesses, and AO type were recorded. Patients were followed at 2, 4, 6, 8, 12 and 24 weeks post fracture. Their pain score (VAS), functional abilities with Mayo wrist score and radiological union were assessed. Statistical analysis was done with student t test and pearson correlation. Results: VAS score improved significantly from 9.57 to 2 in calcitonin group compared to 9.31 to 4.42 in non-calcitonin group. Mayo wrist score showed significant difference in calcitonin group. Fracture union and radiological parameters were comparable in both groups with no statistical significance. CRPS was less frequent in patients who took calcitonin. Conclusion: Calcitonin improves pain and functional outcome in elderly patients with distal radial fractures, reducing the incidence of CRPS. We recommend its routine usage in osteoporotic individuals with distal radial fractures predisposed for CRPS.