In day-to-day practice, progression of bone healing is assessed mainly by clinico-radiological parameters. Furthermore, clinicians are unable to identify the delayed and non-unions early, and even advanced imaging techniques may not be helpful in these cases. To date, the methods used to monitor the bone healing process have been based on the patients’ assessment and the radiographic findings. In view of the fact that patient opinion is highly subjective, that the radiographic findings depend on the radiologist’s experience and that the monitoring of bone healing is a long-lasting process, measurements of biochemical parameters appear to be the only objective evidence of the changes occurring during bone regeneration. The aim of this study was to examine whether the assessment of Serum bone specific ALP (BsALP) as a biochemical parameter in the early posttraumatic phase may indicate the course of fracture healing.
Methods: Changes in BsALP levels were observed at definitive intervals in 30 adult patients (enrolled as per inclusion/exclusion criterion) with closed fresh (within 1 week) traumatic diaphyseal fractures of long bone. All the patients had been surgically treated. Regular follow up of these patients was done till 6 months. The changes in serum BsALP levels were recorded and correlated with the clinico-radiological progression of fracture healing in these patients.
Result: The mean BsALP increased significantly from baseline to 6 and 12 weeks and then decreased significantly at 16 to 24 weeks.
Conclusion: BsALP levels were increased in all cases of closed isolated long bone diaphyseal fractures with maximum increase at 12 weeks and never reached to baseline levels till 24 weeks. The increase in BsAlp levels was more in surgical fixation done with nailing as compared to plating. No relationship was observed between BsALP levels and fracture healing outcome.