Serum Level of Parathyroid Hormone, Alkaline Phosphatase, Calcium and Ionized Calcium After Forearm Fractures

Abdelsamie Halawa; Ahmed Mohamed Morsi; Ahmed Kamel Hassan; Waleed Mohamed Fathy Moussa

doi:doi:10.11648/j.ijbse.20210904.13

| Peer-Reviewed

Serum Level of Parathyroid Hormone, Alkaline Phosphatase, Calcium and Ionized Calcium After Forearm Fractures

Abdelsamie Halawa, Ahmed Mohamed Morsi, Ahmed Kamel Hassan, Waleed Mohamed Fathy Moussa

Published in International Journal of Biomedical Science and Engineering (Volume 9, Issue 4)

Received: 11 October 2021 Accepted: 29 November 2021 Published: 11 December 2021

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Background: During the last decades, our understanding of fracture healing has evolved rapidly. Bone can heal without forming a fibrous scar and, as such, the process of fracture healing recapitulates bone development and may be considered a form of tissue regeneration. The cell and tissue proliferation and differentiation processes involved in fracture healing are regulated by growth factors, inflammatory cytokines, antioxidants, hormones, amino acids, and other nutrients. Objective: To identify changes in serum level of calcium, ionized calcium, alkaline phosphatase and parathyroid hormone according to mode of trauma (low and high energy) in forearm fractures. Patients and Methods: 50 Patients with forearm fracture were prospectively recruited from the emergency department within 48 hours of sustaining the fracture. Patients included in the study were asked to avoid calcium supplementation during fracture healing. Results: Mean PTH was elevated in both groups at Day 1 with low energy group was insignificantly higher than high energy group, whereas after 8 weeks mean PTH level decreased in both groups but in low energy group mean PTH level was significantly higher than high energy group. Mean ALP level increased in both groups at Day 1 whereas in low energy group it was insignificantly higher than that of high energy group, After 8 weeks mean ALP level insignificantly decreased to normal level in both groups. Mean serum calcium level was below normal level in both groups where it was insignificantly higher in high energy group than that of low energy group which increased after 8 weeks in both groups but remained insignificantly elevated in high energy than low energy group. Mean serum ionized calcium level was below normal level at Day 1 in both groups whereas it was insignificantly higher in high energy group than low energy group which after 8 weeks increased in both groups but remained insignificantly elevated in high energy group than low energy group. Conclusion: Serial monitoring of these markers reflect the actual status of bone resorption, and bone formation respectively over a short period. Thus, they can be used as an adjunct to clinical and radiological evidence of fracture healing.

Published in	International Journal of Biomedical Science and Engineering (Volume 9, Issue 4)
DOI	10.11648/j.ijbse.20210904.13
Page(s)	89-95
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Alkaline Phosphatase, Parathyroid Hormone, Forearm Fracture, Biological Markers

References

[1]	Andruszkow H, Pfeifer R, Horst K, Hildebrand F and Pape HC (2015): External fixation in the elderly. Injury. 46: 7-S12.
[2]	Al-Sadek TA, Niklev D and Al-Sadek A (2016): Diaphyseal Fractures of the Forearm in Adults, Plating Or Intramedullary Nailing Is a Better Option for the Treatment. Open access Macedonian journal of medical sciences, 4 (4): 670.
[3]	Mars DR and Li G (1999): The biology of fracture healing: optimizing outcome. British medical bulletin. 55 (4): 856-869.
[4]	Marsell R and Einhorn TA (2011): The biology of fracture healing. Injury. 42 (6): 551-555.
[5]	Ellegaard M, Kringelbach T, Syberg S, Petersen S, Beck Jensen JE, Brüel A. and Schwarz P (2013): The effect of PTH (1-34) on fracture healing during different loading conditions. Journal of Bone and Mineral Research. 28 (10): 2145-2155.
[6]	Aleksynienė R and Hvid I (2004): Parathyroid hormone–possible future drug for orthopedic surgery. Medicina, 40 (9): 842-849.
[7]	Kakar S and Einhorn TA (2004): Importance of nutrition in fracture healing. In Nutrition and Bone Health: Humana Press. pp. 85-103.
[8]	Căpriţă R, Caprita A and Cretescu I (2013): Estimation of ionized calcium and corrected total calcium concentration based on serum albumin level. Scientific Papers Animal Science and Biotechnologies. 46 (1): 180-184.
[9]	Endres DB (2006): Mineral and bone metabolism. Tietz textbook of clinical chemistry and molecular diagnostics. 1891-1924.
[10]	Das S, Ghosh S, Pal K, Chaudhuri A. and Datta S (2015): Changes in biochemical markers in blood and urine in case of malunion and nonunion after fracture of long bones. Saudi Journal of Sports Medicine. 15 (3): 269.
[11]	Kress BC (1998): Theme: biochemical markers of bone metabolism-Bone Alkaline Phosphatase: Methods of Quantitation and Clinical Utility. Journal of Clinical Ligand Assay. 21 (2): 139-148.
[12]	Kumaravel S (2012): A review on the article: Role of common biochemical markers for the assessment of fracture union. Indian Journal of Clinical Biochemistry, 27 (4): 422-425.
[13]	Muljačić A, Poljak-Guberina R, Turčić J, Živković O, Guberina M and Klaić B (2010): The Changes of Bone-Specific Alkaline Phosphatase (BsALP) Associated With Callus Formation and Rate of Bone Healing. Croatica chemica acta. 83 (3): 315-321.
[14]	Boussakri H, Elibrahimi A, Bachiri M, Elidrissi M, Shimi M and Elmrini A (2016): Nonunion of fractures of the ulna and radius diaphyses: clinical and radiological results of surgical treatment. Malaysian orthopaedic journal, 10 (2): 27.
[15]	Kloen P, Buijze GA and Ring D (2012): Management of forearm nonunions: Strategies in Trauma and Limb Reconstruction, 7 (1): 1-11.
[16]	Jafri L, Khan AH, Azeem S (2014): Ionized calcium measurement in serum and plasma by ion selective electrodes: comparison of measured and calculated parameters. Indian J Clin Biochem. 29 (3): 327-32.
[17]	Hoesel LM, Wehr U, Rambeck WA, Schnettler R, Heiss C (2005): Biochemical bone markers are useful to monitor fracture repair. Clinical Orthopaedics and Related Research®, 440: 226-232.
[18]	Mukhopadhyay M, Sinha R, Pal M, Bhattacharyya S, Dan A and Roy MM (2011): Role of common biochemical markers for the assessment of fracture union. Indian Journal of Clinical Biochemistry, 26 (3): 274-278.
[19]	Paskalev M, Krastev S, Filipov J (2005): Changes in some serum bone markers after experimental fracture and intramedullary osteosynthesis in dogs. Trakia J Sci, 3: 46-50.
[20]	Ajai S, Sabir A, Mahdi AA and Srivastava RN (2013): Evaluation of serum alkaline phosphatase as a biomarker of healing process progression of simple diaphyseal fractures in adult patients. Int Res J Biol Sci, 2, 40-3.
[21]	Varma HS and Singh N (2003): Changes in values of serum calcium, serum phosphates and serum alkaline phosphatase following polytrauma. Indian Journal of Orthopaedics, 37 (4): 276.
[22]	Meller Y, Kestenbaum RS, Mozes M, Mozes G, Yagil R, Shany S (1984): Mineral and endocrine metabolism during fracture healing in dogs. Clinical orthopaedics and related research, (187): 289-295.
[23]	Hardy JR, Conlan D, Hay S, Gregg PJ (1993): Serum ionised calcium and its relationship to parathyroid hormone after tibial fracture. The Journal of bone and joint surgery. British volume, 75 (4): 645-649.
[24]	Gruys E, Toussaint MJ, Niewold TA, Koopmans SJ (2005): Acute phase reaction and acute phase proteins. Journal of Zhejiang University. Science. B, 6 (11): 1045.
[25]	Theman TA and Collins MT (2009): The role of the calcium-sensing receptor in bone biology and pathophysiology. Current pharmaceutical biotechnology, 10 (3): 289-301.

Cite This Article

Plain Text BibTeX RIS

APA Style

Abdelsamie Halawa, Ahmed Mohamed Morsi, Ahmed Kamel Hassan, Waleed Mohamed Fathy Moussa. (2021). Serum Level of Parathyroid Hormone, Alkaline Phosphatase, Calcium and Ionized Calcium After Forearm Fractures. International Journal of Biomedical Science and Engineering, 9(4), 89-95. https://doi.org/10.11648/j.ijbse.20210904.13

Copy | Download

ACS Style

Abdelsamie Halawa; Ahmed Mohamed Morsi; Ahmed Kamel Hassan; Waleed Mohamed Fathy Moussa. Serum Level of Parathyroid Hormone, Alkaline Phosphatase, Calcium and Ionized Calcium After Forearm Fractures. Int. J. Biomed. Sci. Eng. 2021, 9(4), 89-95. doi: 10.11648/j.ijbse.20210904.13

Copy | Download

AMA Style

Abdelsamie Halawa, Ahmed Mohamed Morsi, Ahmed Kamel Hassan, Waleed Mohamed Fathy Moussa. Serum Level of Parathyroid Hormone, Alkaline Phosphatase, Calcium and Ionized Calcium After Forearm Fractures. Int J Biomed Sci Eng. 2021;9(4):89-95. doi: 10.11648/j.ijbse.20210904.13

Copy | Download

@article{10.11648/j.ijbse.20210904.13,
  author = {Abdelsamie Halawa and Ahmed Mohamed Morsi and Ahmed Kamel Hassan and Waleed Mohamed Fathy Moussa},
  title = {Serum Level of Parathyroid Hormone, Alkaline Phosphatase, Calcium and Ionized Calcium After Forearm Fractures},
  journal = {International Journal of Biomedical Science and Engineering},
  volume = {9},
  number = {4},
  pages = {89-95},
  doi = {10.11648/j.ijbse.20210904.13},
  url = {https://doi.org/10.11648/j.ijbse.20210904.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijbse.20210904.13},
  abstract = {Background: During the last decades, our understanding of fracture healing has evolved rapidly. Bone can heal without forming a fibrous scar and, as such, the process of fracture healing recapitulates bone development and may be considered a form of tissue regeneration. The cell and tissue proliferation and differentiation processes involved in fracture healing are regulated by growth factors, inflammatory cytokines, antioxidants, hormones, amino acids, and other nutrients. Objective: To identify changes in serum level of calcium, ionized calcium, alkaline phosphatase and parathyroid hormone according to mode of trauma (low and high energy) in forearm fractures. Patients and Methods: 50 Patients with forearm fracture were prospectively recruited from the emergency department within 48 hours of sustaining the fracture. Patients included in the study were asked to avoid calcium supplementation during fracture healing. Results: Mean PTH was elevated in both groups at Day 1 with low energy group was insignificantly higher than high energy group, whereas after 8 weeks mean PTH level decreased in both groups but in low energy group mean PTH level was significantly higher than high energy group. Mean ALP level increased in both groups at Day 1 whereas in low energy group it was insignificantly higher than that of high energy group, After 8 weeks mean ALP level insignificantly decreased to normal level in both groups. Mean serum calcium level was below normal level in both groups where it was insignificantly higher in high energy group than that of low energy group which increased after 8 weeks in both groups but remained insignificantly elevated in high energy than low energy group. Mean serum ionized calcium level was below normal level at Day 1 in both groups whereas it was insignificantly higher in high energy group than low energy group which after 8 weeks increased in both groups but remained insignificantly elevated in high energy group than low energy group. Conclusion: Serial monitoring of these markers reflect the actual status of bone resorption, and bone formation respectively over a short period. Thus, they can be used as an adjunct to clinical and radiological evidence of fracture healing.},
 year = {2021}
}

Copy | Download

TY  - JOUR
T1  - Serum Level of Parathyroid Hormone, Alkaline Phosphatase, Calcium and Ionized Calcium After Forearm Fractures
AU  - Abdelsamie Halawa
AU  - Ahmed Mohamed Morsi
AU  - Ahmed Kamel Hassan
AU  - Waleed Mohamed Fathy Moussa
Y1  - 2021/12/11
PY  - 2021
N1  - https://doi.org/10.11648/j.ijbse.20210904.13
DO  - 10.11648/j.ijbse.20210904.13
T2  - International Journal of Biomedical Science and Engineering
JF  - International Journal of Biomedical Science and Engineering
JO  - International Journal of Biomedical Science and Engineering
SP  - 89
EP  - 95
PB  - Science Publishing Group
SN  - 2376-7235
UR  - https://doi.org/10.11648/j.ijbse.20210904.13
AB  - Background: During the last decades, our understanding of fracture healing has evolved rapidly. Bone can heal without forming a fibrous scar and, as such, the process of fracture healing recapitulates bone development and may be considered a form of tissue regeneration. The cell and tissue proliferation and differentiation processes involved in fracture healing are regulated by growth factors, inflammatory cytokines, antioxidants, hormones, amino acids, and other nutrients. Objective: To identify changes in serum level of calcium, ionized calcium, alkaline phosphatase and parathyroid hormone according to mode of trauma (low and high energy) in forearm fractures. Patients and Methods: 50 Patients with forearm fracture were prospectively recruited from the emergency department within 48 hours of sustaining the fracture. Patients included in the study were asked to avoid calcium supplementation during fracture healing. Results: Mean PTH was elevated in both groups at Day 1 with low energy group was insignificantly higher than high energy group, whereas after 8 weeks mean PTH level decreased in both groups but in low energy group mean PTH level was significantly higher than high energy group. Mean ALP level increased in both groups at Day 1 whereas in low energy group it was insignificantly higher than that of high energy group, After 8 weeks mean ALP level insignificantly decreased to normal level in both groups. Mean serum calcium level was below normal level in both groups where it was insignificantly higher in high energy group than that of low energy group which increased after 8 weeks in both groups but remained insignificantly elevated in high energy than low energy group. Mean serum ionized calcium level was below normal level at Day 1 in both groups whereas it was insignificantly higher in high energy group than low energy group which after 8 weeks increased in both groups but remained insignificantly elevated in high energy group than low energy group. Conclusion: Serial monitoring of these markers reflect the actual status of bone resorption, and bone formation respectively over a short period. Thus, they can be used as an adjunct to clinical and radiological evidence of fracture healing.
VL  - 9
IS  - 4
ER  -

Copy | Download

Author Information

Abdelsamie Halawa

Ortthopedic Department, Benha University, Benha, Egypt
Ahmed Mohamed Morsi

Orthopedic Department, Ain Shams University, Cairo, Egypt
Ahmed Kamel Hassan

Orthopedic Department, Ain Shams University, Cairo, Egypt
Waleed Mohamed Fathy Moussa

Ortthopedic Department, Benha University, Benha, Egypt

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Abdelsamie Halawa, Ahmed Mohamed Morsi, Ahmed Kamel Hassan, Waleed Mohamed Fathy Moussa. (2021). Serum Level of Parathyroid Hormone, Alkaline Phosphatase, Calcium and Ionized Calcium After Forearm Fractures. International Journal of Biomedical Science and Engineering, 9(4), 89-95. https://doi.org/10.11648/j.ijbse.20210904.13

Copy | Download

ACS Style

Abdelsamie Halawa; Ahmed Mohamed Morsi; Ahmed Kamel Hassan; Waleed Mohamed Fathy Moussa. Serum Level of Parathyroid Hormone, Alkaline Phosphatase, Calcium and Ionized Calcium After Forearm Fractures. Int. J. Biomed. Sci. Eng. 2021, 9(4), 89-95. doi: 10.11648/j.ijbse.20210904.13

Copy | Download

AMA Style

Abdelsamie Halawa, Ahmed Mohamed Morsi, Ahmed Kamel Hassan, Waleed Mohamed Fathy Moussa. Serum Level of Parathyroid Hormone, Alkaline Phosphatase, Calcium and Ionized Calcium After Forearm Fractures. Int J Biomed Sci Eng. 2021;9(4):89-95. doi: 10.11648/j.ijbse.20210904.13

Copy | Download

@article{10.11648/j.ijbse.20210904.13,
  author = {Abdelsamie Halawa and Ahmed Mohamed Morsi and Ahmed Kamel Hassan and Waleed Mohamed Fathy Moussa},
  title = {Serum Level of Parathyroid Hormone, Alkaline Phosphatase, Calcium and Ionized Calcium After Forearm Fractures},
  journal = {International Journal of Biomedical Science and Engineering},
  volume = {9},
  number = {4},
  pages = {89-95},
  doi = {10.11648/j.ijbse.20210904.13},
  url = {https://doi.org/10.11648/j.ijbse.20210904.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijbse.20210904.13},
  abstract = {Background: During the last decades, our understanding of fracture healing has evolved rapidly. Bone can heal without forming a fibrous scar and, as such, the process of fracture healing recapitulates bone development and may be considered a form of tissue regeneration. The cell and tissue proliferation and differentiation processes involved in fracture healing are regulated by growth factors, inflammatory cytokines, antioxidants, hormones, amino acids, and other nutrients. Objective: To identify changes in serum level of calcium, ionized calcium, alkaline phosphatase and parathyroid hormone according to mode of trauma (low and high energy) in forearm fractures. Patients and Methods: 50 Patients with forearm fracture were prospectively recruited from the emergency department within 48 hours of sustaining the fracture. Patients included in the study were asked to avoid calcium supplementation during fracture healing. Results: Mean PTH was elevated in both groups at Day 1 with low energy group was insignificantly higher than high energy group, whereas after 8 weeks mean PTH level decreased in both groups but in low energy group mean PTH level was significantly higher than high energy group. Mean ALP level increased in both groups at Day 1 whereas in low energy group it was insignificantly higher than that of high energy group, After 8 weeks mean ALP level insignificantly decreased to normal level in both groups. Mean serum calcium level was below normal level in both groups where it was insignificantly higher in high energy group than that of low energy group which increased after 8 weeks in both groups but remained insignificantly elevated in high energy than low energy group. Mean serum ionized calcium level was below normal level at Day 1 in both groups whereas it was insignificantly higher in high energy group than low energy group which after 8 weeks increased in both groups but remained insignificantly elevated in high energy group than low energy group. Conclusion: Serial monitoring of these markers reflect the actual status of bone resorption, and bone formation respectively over a short period. Thus, they can be used as an adjunct to clinical and radiological evidence of fracture healing.},
 year = {2021}
}

Copy | Download

TY  - JOUR
T1  - Serum Level of Parathyroid Hormone, Alkaline Phosphatase, Calcium and Ionized Calcium After Forearm Fractures
AU  - Abdelsamie Halawa
AU  - Ahmed Mohamed Morsi
AU  - Ahmed Kamel Hassan
AU  - Waleed Mohamed Fathy Moussa
Y1  - 2021/12/11
PY  - 2021
N1  - https://doi.org/10.11648/j.ijbse.20210904.13
DO  - 10.11648/j.ijbse.20210904.13
T2  - International Journal of Biomedical Science and Engineering
JF  - International Journal of Biomedical Science and Engineering
JO  - International Journal of Biomedical Science and Engineering
SP  - 89
EP  - 95
PB  - Science Publishing Group
SN  - 2376-7235
UR  - https://doi.org/10.11648/j.ijbse.20210904.13
AB  - Background: During the last decades, our understanding of fracture healing has evolved rapidly. Bone can heal without forming a fibrous scar and, as such, the process of fracture healing recapitulates bone development and may be considered a form of tissue regeneration. The cell and tissue proliferation and differentiation processes involved in fracture healing are regulated by growth factors, inflammatory cytokines, antioxidants, hormones, amino acids, and other nutrients. Objective: To identify changes in serum level of calcium, ionized calcium, alkaline phosphatase and parathyroid hormone according to mode of trauma (low and high energy) in forearm fractures. Patients and Methods: 50 Patients with forearm fracture were prospectively recruited from the emergency department within 48 hours of sustaining the fracture. Patients included in the study were asked to avoid calcium supplementation during fracture healing. Results: Mean PTH was elevated in both groups at Day 1 with low energy group was insignificantly higher than high energy group, whereas after 8 weeks mean PTH level decreased in both groups but in low energy group mean PTH level was significantly higher than high energy group. Mean ALP level increased in both groups at Day 1 whereas in low energy group it was insignificantly higher than that of high energy group, After 8 weeks mean ALP level insignificantly decreased to normal level in both groups. Mean serum calcium level was below normal level in both groups where it was insignificantly higher in high energy group than that of low energy group which increased after 8 weeks in both groups but remained insignificantly elevated in high energy than low energy group. Mean serum ionized calcium level was below normal level at Day 1 in both groups whereas it was insignificantly higher in high energy group than low energy group which after 8 weeks increased in both groups but remained insignificantly elevated in high energy group than low energy group. Conclusion: Serial monitoring of these markers reflect the actual status of bone resorption, and bone formation respectively over a short period. Thus, they can be used as an adjunct to clinical and radiological evidence of fracture healing.
VL  - 9
IS  - 4
ER  -

Copy | Download