Abstract: Background: Intertrochanteric fractures often result from trivial injury in the old age patient and is a fracture occurring outside the joint capsule. Calcitonin has been used to treat patients with hip fracture because it is a potent inhibitor of bone resorption. However, its role in decreasing pain intensity, promoting early mobilization and fracture healing is still under debate.
Method: We conducted a placebo controlled prospective study over two years from 2018 to 2019 to assess the role of salmon calcitonin administered intranasally, in terms of analgesia and early fracture healing in 40 patients randomised into two groups. Group 1 given intramuscular calcitonin for 7 days followed by intranasal till 10 weeks while group 2 received placebo (Normal saline). Patients were followed up till 10 weeks post-operatively. The mean age was 50.5 years (range 32 years to 68 years) with 28 (70%) female and 12 (30%) male patients and the commonest cause of injury was fall from standing position (80%).
Results: There was statistically significant difference between the minimum Rush score in Interventional group vs control group at 6th week and 10th week (23 vs 18; 29 vs 23) and maximum score (26 vs 21; 30 vs 28). Similarly, intensity of the pain at 1st, 6th and 10th week using WILCOXEN TEST was significantly reduced (p value <0.0001) in test group and control group (p value <0.0001). Similarly, inter-group comparison of intensity of pain as calculated by VAS score at 1st, 6th & 10th week using MANN-WHITNEY test showed that the interventional group had a lesser intensity of pain as compared to the control group (p value <0.0001) helping in early mobilization of the patients.
Conclusion: Rate of fracture healing was faster showing early fracture union, complete consolidation of fracture, early disappearance of fracture line and reduced intensity of pain in calcitonin treated group, Hence, therapy of combined intramuscular and intranasal salmon calcitonin given post operatively is useful for early healing and repair of intertrochanteric fractures and offers immediate and lasting pain relief.
