HEALING of LONG BONE FRACTURES in PATIENTS with CONCOMITANT HEAD or SPINAL CORD INJURIES

The aim of this prospective controlled study is to compare healing rate and amount of union callus formed in patients with long bone fractures and concomitant head or spinal cord injuries to patients with long bone fractures only. The healing markers of fractures were compared in three groups of patients: (A) patients with head injuries and long bone fractures, (B) patients with acute traumatic spinal cord injuries and long bone fractures, and (C) patients with long bone fractures only. The mean (range) time to union of long bone fractures in groups (A), (B), and (C) patients was 6.9 (3-20), 6.2 (3-7.7), and 22.4 (13-41) weeks. The mean (range) healing rate of long bone fractures in groups (A), (B), and (C) patients was 4.5(0.2-10.6), 4.7 (2.6-7.5), and 0.38(0.11-1) mm/week. The mean (range) thickness of callus formed at fracture sites in groups (A), (B), and (C) patients was 26(4-48), 29(10-48), and 1(2-20)mm. There were no cases of delayed or nonunion in groups (A) and (B) patients while 5 of 69 fractures (7.3%) had delayed union in group (C) and 9/69 (13%) fractures had nonunion. These results suggest acceleration of long bone fractures in patients with head or spinal cord injuries.