Document Detail

Humoral factors enhance fracture-healing and callus formation in patients with traumatic brain injury.
MedLine Citation:
PMID:  19181971     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Scientific evidence is mounting for an association between traumatic brain injury and enhanced osteogenesis. The aim of this study was to correlate the in vitro osteoinductive potential of serum with the features of fracture-healing and the extent of brain damage in patients with severe traumatic brain injury and bone fracture. METHODS: Patients with a long-bone fracture and a traumatic brain injury (seventeen patients) or without a brain injury (twenty-four patients) were recruited. The Glasgow Coma Scale score was determined on admission. Radiographs of the fracture were made before surgery, at six weeks, and at three, six, and twelve months after surgery. The time to union was estimated clinically and radiographically, and the callus ratio to shaft diameter was calculated. Serum samples were collected at six, twenty-four, seventy-two, and 168 hours after injury, and their osteogenic potential was determined by measurement of the in vitro proliferation rate of the human fetal osteoblastic cell line hFOB1.19. RESULTS: Patients with a traumatic brain injury had a twofold shorter time to union (p = 0.01), a 37% to 50% increased callus ratio (p < 0.01), and their sera induced a higher proliferation rate in hFOB cells (p < 0.05). A linear relationship was revealed between hFOB cell proliferation rates and the amount of callus formed (p < 0.05). The Glasgow Coma Scale score was correlated with the callus ratio on both radiographic projections (p < 0.05), time to union (p = 0.04), and the proliferation rate of hFOB cells at six hours after injury (p = 0.03). CONCLUSIONS: Patients with a severe brain injury release unknown humoral factors into the blood circulation that enhance and accelerate fracture-healing.
Dieter Cadosch; Oliver P Gautschi; Matthew Thyer; Swithin Song; Allan P Skirving; Luis Filgueira; René Zellweger
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of bone and joint surgery. American volume     Volume:  91     ISSN:  1535-1386     ISO Abbreviation:  J Bone Joint Surg Am     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-02-02     Completed Date:  2009-02-23     Revised Date:  2010-10-25    
Medline Journal Info:
Nlm Unique ID:  0014030     Medline TA:  J Bone Joint Surg Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  282-8     Citation Subset:  AIM; IM    
Royal Perth Hospital, Perth, Western Australia, Australia.
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MeSH Terms
Alkaline Phosphatase / blood
Bony Callus / physiopathology*
Brain Injuries / blood,  physiopathology,  surgery*
C-Reactive Protein / analysis
Calcium / blood
Cell Proliferation
Fracture Healing / physiology*
Middle Aged
Parathyroid Hormone / blood
Young Adult
Reg. No./Substance:
0/Parathyroid Hormone; 7440-70-2/Calcium; 9007-41-4/C-Reactive Protein; EC Phosphatase
Erratum In:
J Bone Joint Surg Am. 2009 Apr;91(4):938

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