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Human growth hormone in delayed union and non-union of fractures

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Summary

1. Human growth hormone (HGH) was administered to a series of 20 adult patients admitted to hospital because of delayed union or non-union of a fracture of a long bone. They included 15 tibial shaft fractures and other bone lesions with a poor prognosis for consolidation. Their progress was studied and compared with suitable controls.

2. Bone union occurred in all 20 patients and the time required for stabilization was 8 weeks or less in 12 cases, and 12 weeks or less in 17 cases (60% and 85% of the series respectively). No excessive callus formation was observed.

3. Several metabolic parameters indicative of active bone metabolism showed an increase from the start of HGH treatment up to 3 weeks, followed by either decline or a constant up to 5 weeks.

4. The endogenous serum HGH level was strikingly low and presented a negative correlation with the consolidation time.

The rapid consolidation of the fractures suggested that HGH therapy has a bone union promoting effect.

Résumé

1. L'hormone humaine de croissance (HHC) a été administrée à une série de 20 malades hospitalisés pour retard de consolidation ou pseudarthrose diaphysaire. Parmi eux, il y avait 15 fractures du tibia et d'autres lésions osseuses dont la consolidation paraissait compromise. Leur évolution a été étudiée et comparée à celle d'un groupe témoin.

2. La consolidation a été obtenue chez les 20 malades, en 8 semaines ou moins dans 12 cas et en 12 semaines ou moins dans 17 cas (soit 60% et 85% de la série). Il n'y a pas eu de cal hypertrophique.

3. Plusieurs paramètres en relation avec un métabolisme osseux actif ont augmenté pendant les 3 semaines qui ont suivi la mise en route du traitement par l'HHC, puis sont restés au même niveau ou ontdiminué jusqu'à la 5éme semaine.

4. L'HHC sérique d'origine endogène était à un niveau extrêmement bas, en relation inverse avec la durée de la consolidation.

L'obtention rapide de la consolidation de ces fractures permet de penser que le traitement par l'HHC exerce un effet favorable sur la fusion osseuse.

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References

  1. Bauer, G. C. H., Edvards, P., Widmark, P. H.: Shaft fractures of the tibia. Etiology of poor results in a consecutive series of 173 fractures. Acta Chir. Scand124 386–395 (1962)

  2. Carpenter, E. B., Debbie, J. J., Siewers, C. F.: Fractures of the shaft of the tibia and fibula. Comparative end results from various types of treatment in a teaching hospital. Arch. Surg.64 443–45 (1952)

  3. Ellis, H.: The speed of healing after fracture of the tibial shaft. J. Bone Joint Surg.40-B 42–46 (1958)

  4. Frost, H. M., Villanueva, A. R., Roth, H.: Measurement of bone formation in a 57-year-old man by means of tetracyclines. Henry Ford Hospital Memorial Bulletin8 239–254 (1960)

  5. Jernberger, A.: Measurement of stability of tibial fractures. A mechanical method. Acta Orth. Scand. [Suppl.]135 1–88 (1970)

  6. Koskinen, E. V. S.: The effect of growth hormone and thyrotropin on human fracture healing. A clinical, quantitative, radiographic and metabolic study. Acta Orthop. Scand. [Suppl.]62 1–68 (1963)

  7. Koskinen, E. V. S.: Clinical and metabolic effects of hormonal treatment in bone repair. In: Calcified tissues, L. J. Richelle and M. J. Dallemagne, eds. Liège: Collection des Colloques de l'Université de Liège 1965

  8. Koskinen, E. V. S., Ryöppy, S. A., Lindholm, S.: Osteoinduction and osteogenesis in implants of allogenic bone matrix. Influence of somatotropin, thyrotropin and cortisone. Clin. Orthop.87 116–131 (1972)

  9. Lacroix, P.: The organization of bones. Philadelphia: Blakiston 1951

  10. Misol, S., Samaan, N., Ponseti, I. V.: Growth hormone in delayed fracture union. Clin. Orthop.74 206–208 (1971)

  11. Nicoll, E. A.: Fractures of the tibial shaft: A survey of 705 cases. J. Bone Joint Surg.46-B 373–387 (1964)

  12. Slätis, P., Rokkanen, P.: Closed intramedullary nailing of tibial shaft fractures. A comparison with conservatively treated cases. Acta Orthop. Scand.38 88–100 (1967)

  13. Souter, W. A.: Autogenous cancellous strip grafts in the treatment of delayed union of long bone fractures. J. Bone Joint Surg.51-B 63–75 (1969)

  14. Urist, M. R., McLean, F. C.: Calcification and ossification. I. Calcification in the callus in healing fractures in normal rats. J. Bone Joint Surg.23 1–16 (1941)

  15. Urist, M. R., McLean, F. C.: Recent advances in physiology of bone. J. Bone Joint Surg.45-A 1305–1313 (1963)

  16. Weissman, S. L., Herold, H. Z., Engelberg, M.: Fractures of the middle two-thirds of the tibial shaft. J. Bone Joint Surg.48-A 257–267 (1966)

  17. Wray, J. D., Goldstein, J.: The effects of the pituitary gland and growth hormone upon the strength of the healing fracture in the rat. J. Bone Joint Surg.48-A 815–816 (1966)

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Correspondence to Erkki V. S. Koskinen.

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Koskinen, E.V.S., Lindholm, R.V., Nieminen, R.A. et al. Human growth hormone in delayed union and non-union of fractures. International Orthopaedics 1, 317–322 (1978). https://doi.org/10.1007/BF00572258

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Key words

  • Fracture
  • Non-united fracture
  • Growth hormone