PDF(Pubmed)
Abstract：
OBJECTIVE: Tibial diaphysis fractures are common injuries resulting from high-to-low-energy traumas in patients of all age groups, but few reports currently provide complementary parameters for the assessment of bone healing processes in the postoperative period. Serum alkaline phosphatase (ALP) and the scores from the Radiographic Union Scale for Tibial Fractures (RUST) can promote new horizons in this context. Therefore, the aim of this study was to assess the behavior of ALP and RUST through within-subject comparisons from immediately post-surgery to 49 days after tibial diaphysis fracture repair.
METHODS: This article included four case studies where patients underwent the same procedures. Adults of both sexes aged 18 to 60 years with tibial fractures requiring surgery were included. After surgical intervention (T1), the patients were followed for 49 days after surgery, returning for follow-up appointments on the 21st (T2) and 49th (T3) days. At the follow-up appointments, new X-ray images were obtained, and blood samples were collected for ALP measurement.
RESULTS: Serum ALP levels increased by T2 following tibial reamed intramedullary nailing surgery. While this increase persisted into T3 for two patients, a decline was observed during the same period for the other two patients. Both events are indicative of the bone consolidation process, and RUST scores at the T3 corroborate this perspective for all patients included in this study. Considering that delta ALP (T3-T1 value) was lower in patients who exhibited the highest RUST score, we suggest that a synchronized analysis between ALP and RUST allows medics to diagnose bone consolidation.
CONCLUSIONS: Therefore, it can be concluded that the analysis of ALP alongside RUST may be complementary for evaluating bone consolidation following tibial reamed intramedullary nailing surgery, but future studies are needed to confirm this assertion.
METHODS: This article included four case studies where patients underwent the same procedures. Adults of both sexes aged 18 to 60 years with tibial fractures requiring surgery were included. After surgical intervention (T1), the patients were followed for 49 days after surgery, returning for follow-up appointments on the 21st (T2) and 49th (T3) days. At the follow-up appointments, new X-ray images were obtained, and blood samples were collected for ALP measurement.
RESULTS: Serum ALP levels increased by T2 following tibial reamed intramedullary nailing surgery. While this increase persisted into T3 for two patients, a decline was observed during the same period for the other two patients. Both events are indicative of the bone consolidation process, and RUST scores at the T3 corroborate this perspective for all patients included in this study. Considering that delta ALP (T3-T1 value) was lower in patients who exhibited the highest RUST score, we suggest that a synchronized analysis between ALP and RUST allows medics to diagnose bone consolidation.
CONCLUSIONS: Therefore, it can be concluded that the analysis of ALP alongside RUST may be complementary for evaluating bone consolidation following tibial reamed intramedullary nailing surgery, but future studies are needed to confirm this assertion.
摘要：
目的：胫骨干骨折是所有年龄段患者高-低能量损伤引起的常见损伤，但是目前很少有报告提供用于评估术后骨愈合过程的补充参数。在这种情况下，血清碱性磷酸酶（ALP）和胫骨骨折影像学联合量表（RUST）的评分可以促进新的视野。因此,本研究的目的是通过从术后即刻到胫骨干骨折修复后49天的受试者内比较,评估ALP和RUST的行为.
方法：本文包括4例患者接受相同手术的病例研究。包括年龄在18至60岁之间的胫骨骨折需要手术的成年人。手术干预后（T1），术后随访49天,在第21天（T2）和第49天（T3）返回随访。在后续任命中，获得了新的X射线图像，收集血样进行ALP测量。
结果：胫骨扩髓髓内钉手术后血清ALP水平随T2升高。虽然这种增加持续到两名患者的T3，在同一时期观察到其他两名患者的下降。这两个事件都表明骨巩固过程，T3时的RUST评分证实了本研究中所有患者的这一观点.考虑到RUST评分最高的患者的ΔALP（T3-T1值）较低，我们建议ALP和RUST之间的同步分析允许医生诊断骨巩固.
结论：因此，可以得出结论，ALP与RUST的分析可能是评估胫骨扩髓髓内钉手术后骨巩固的补充，但未来的研究需要证实这一说法。
方法：本文包括4例患者接受相同手术的病例研究。包括年龄在18至60岁之间的胫骨骨折需要手术的成年人。手术干预后（T1），术后随访49天,在第21天（T2）和第49天（T3）返回随访。在后续任命中，获得了新的X射线图像，收集血样进行ALP测量。
结果：胫骨扩髓髓内钉手术后血清ALP水平随T2升高。虽然这种增加持续到两名患者的T3，在同一时期观察到其他两名患者的下降。这两个事件都表明骨巩固过程，T3时的RUST评分证实了本研究中所有患者的这一观点.考虑到RUST评分最高的患者的ΔALP（T3-T1值）较低，我们建议ALP和RUST之间的同步分析允许医生诊断骨巩固.
结论：因此，可以得出结论，ALP与RUST的分析可能是评估胫骨扩髓髓内钉手术后骨巩固的补充，但未来的研究需要证实这一说法。
