HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (1) Citing Articles via Google Scholar Google Scholar Articles by Raschke, M. Articles by Christiansen, J. S. Search for Related Content PubMed PubMed Citation Articles by Raschke, M. Articles by Christiansen, J. S.

Effects of growth hormone in patients with tibial fracture: a randomised, double-blind, placebo-controlled clinical trial

Department of Trauma-, Hand and Reconstructive Surgery, University Hospital of Münster, Münster, Germany, ¹ Novo Nordisk, Bagsvaerd, Denmark, ² Departments of Orthopaedic Surgery, University Hospital of Natal, Durban, South Africa, ³ Hadassah Hebrew University Hospital, Jerusalem, Israel and ⁴ Department of Endocrinology and Diabetes, University Hospital of Aarhus, DK-8000 Aarhus, Denmark

(Correspondence should be addressed to J S Christiansen; Email: jsc{at}afdm.au.dk.)

Objective: Investigate whether intervention with GH after tibial fracture enhances fracture healing.

Design: Randomised, double-blind, placebo-controlled study in 406 patients (93 women, 313 men, age: 18–64 years) with tibial fracture.

Methods: Patients were stratified by tibial fracture (open or closed) and allocated to placebo or GH treatment (15, 30 or 60 µg/kg daily, until clinically assessed healing or until 16 weeks post-surgery). Primary outcome was time from surgery until fracture healing and assessment of healing was done centrally and observer blinded. Patients reported for evaluation every 4 weeks until 24 weeks, and at 9 and 12 months.

Results: GH did not accelerate time to healing in the combined group of open and closed fractures. When separately analysing the closed and open fractures, a significant difference in time to healing was observed between treatment groups, exclusively in the closed fractures (P<0.05; subgroup analysis revealed that the 60 µg/kg group was significantly different from placebo). The relative risk of fracture healing for 60 µg/kg versus placebo during the 12 month was: all fractures, 1.16; 95% CI: (0.86; 1.57) (ns); closed fractures, 1.44; 95% CI: (1.01; 2.05; P<0.05); open fractures, 0.75; 95% CI: (0.42; 1.31) (ns). The estimated median number of days before fracture healing in closed fractures was 95 with 60 µg/kg versus 129 with placebo (95% CI: (94; 129) and (94; 249)) corresponding to approximately 26% decrease in healing time.

Conclusions: In the overall group of open and closed tibial fractures, no significant enhancement of fracture healing was observed with GH, whereas in closed tibial fractures, GH accelerated healing significantly.

This article has been cited by other articles:

				S. Doessing, K. M. Heinemeier, L. Holm, A. L. Mackey, P. Schjerling, M. Rennie, K. Smith, Sør. Reitelseder, A.-M. Kappelgaard, M. Høj. Rasmussen, et al. Growth hormone stimulates the collagen synthesis in human tendon and skeletal muscle without affecting myofibrillar protein synthesis J. Physiol., January 15, 2010; 588(2): 341 - 351. [Abstract] [Full Text] [PDF]