MARKERS OF BONE METABOLISM IN LONG BONE’S ADHESION

Abstract

This review presents the current evidence about the use of markers of bone metabolism in the prediction of fracture healing, differences in concentrations of blood markers of bone metabolism in patients with normal and delayed consolidation of bone fragments. We analyze the relationship between the fracture site, time-stage features of its healing and urinary macromolecules, reflecting bone metabolism. Increase in bone turnover, which is observed after the fracture, is characterized by activation markers of bone resorption, with a subsequent increase in the concentration of blood markers of bone formation. However, there is a marked variability in data concerning the levels of bone markers in plasma at different stages of fracture healing. We show that in patients with delayed fracture healing there is a significant delay in raising osteocalcin levels. Prognostic features for determining fracture nonunion include low concentrations of N-terminal propeptide of procollagen type I. Determination of markers of bone metabolism in blood can serve as informative criterion for the course of reparative osteogenesis, but one must consider the nature of traumatic injury, time passed from injury, especially the state of bone tissue at the time of injury, age of the patient to identify the early stages of consolidation disturbances.