Study of Serum Vascular endothelial growth factor level in Patients with Simple Diaphyseal Fractures healing

Abstract

Background & Objectives: Vascular endothelial growth factor (VEGF) plays an important role in the bone repair process by acting as a potent mediator of angiogenesis. In the present study, we aim to analyse the temporal expression of serum VEGF during the early phase of fracture healing and further correlate it with the fracture healing outcomes. Methods: In this longitudinal cohort study, as per inclusion- exclusion criteria, total 76 adult patients with simple, fresh traumatic diaphyseal fractures of both bones of leg managed conservatively; were enrolled. The VEGF examination was carried out by taking venous blood (2ml) at 4th, 7th, 10th, 15th and 20th day after trauma and clinico-radiological examination was done at 6th, 10th 16th, 20th and 24th week after post trauma. As per clinico-radiological outcomes, these patients were divided into normal healing and impaired healing groups. These healing outcomes then were correlated with serum VEGF level in both groups. Results: Difference between the demographic variables of both groups was statistically insignificant. The mean RUST Score in each follow up except the baseline value shows statistically significant difference. The serum VEGF level seem to higher in impaired healing patients (Group-II) as compared to the normal healing patients (Group-I) in each follow-ups, however stastically, they shows insignificant difference. Further the correlation between healing outcomes with serum VEGF level was also found to be insignificant. Interpretation & Conclusions: The serum VEGF act as an potent mediator of angiogenesis during the early phase of healing and can be used as a biomarker to predict the progress of fracture healing outcomes. Key Word: Vascular endothelial growth factor, Diphyseal tibial fracture, simple fracture