EVALUATION OF SERUM ALKALINE PHOSPHATASE AND OSTEOCALCIN AS PREDICTORS OF BONE HEALING AFTER INTERNAL FIXATION
DOI:
https://doi.org/10.53350/Annalspakmed.1.2.13Abstract
and matrix mineralization. Early detection of delayed union is vital for optimal management. Biochemical markers such as serum alkaline phosphatase (ALP) and osteocalcin (OC) reflect osteoblastic function and bone turnover and may serve as early predictors of bone healing.
Objective: To evaluate serum ALP and osteocalcin levels as biochemical predictors of bone healing following internal fixation of long bone fractures.
Methods: A cross-sectional observational study was conducted at tertiary care centers across Punjab, Pakistan, from January 2023 to February 2025, including 100 patients aged 18–60 years who underwent internal fixation for long bone fractures. Blood samples were collected at 2, 6, and 12 weeks postoperatively for ALP and OC estimation using kinetic photometric and ELISA methods, respectively. Radiological healing was assessed using the Radiographic Union Scale for Tibial fractures (RUST). Data were analyzed using SPSS v26, applying paired t-test and Pearson correlation.
Results: The mean ALP and osteocalcin levels showed a significant rise from 2 to 12 weeks (p < 0.001). ALP correlated strongly with RUST score (r = 0.72), while osteocalcin showed a moderate correlation (r = 0.66). Patients with normal union had significantly higher ALP and OC levels compared to delayed union cases.
Conclusion: Serum ALP and osteocalcin are reliable biochemical markers for monitoring bone healing after internal fixation. Their sequential evaluation complements radiographic findings and enables early detection of delayed healing.
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Copyright (c) 2025 AMEER HAMZA, MUHAMMAD AHMED, AREEJ KHALID, ANEELA SHAHZADI, MUHAMMAD TAHA, MUHAMMAD MOGHEES AFZAL
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