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Journal of Bone and Joint Surgery - British Volume, Vol 86-B, Issue 3, 350-358.
doi: 10.1302/0301-620X.86B3.14300  
Copyright © 2004 by British Editorial Society of Bone and Joint Surgery
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The effects of calcitonin on acute bone loss after pertrochanteric fractures

A PROSPECTIVE, RANDOMISED TRIAL

T. Karachalios, MD, Assistant Professor in Orthopaedics1; G. P. Lyritis, MD, Associate Professor in Orthopaedics2; J. Kaloudis, MD, Specialist in Orthopaedic Surgery2; N. Roidis, MD, Specialist in Orthopaedic Surgery1; and M. Katsiri, Medical Technician2

1 Orthopaedic Department, School of Medicine, Faculty of Health Sciences, University of Thessaly, 22 Papakyriazi Street, Larissa 41222, Greece.
2 Laboratory for the Reseach of the Musculoskeletal System "T. Garofalidis", KAT Hospital, University of Athens, Kifisia 14561, Athens, Greece.

Correspondence should be sent to Dr T. Karachalios.

We investigated the effect of calcitonin in the prevention of acute bone loss after a pertrochanteric fracture and its ability to reduce the incidence of further fractures in the same patient.

Fifty women aged between 70 and 80 years who had a pertrochanteric fracture of the hip were randomly allocated to group A (200 IU of nasal salmon calcitonin daily for three months) or group B (placebo).

Patients in group A showed a significantly higher level of total alkaline phosphatase and osteocalcin on the 15th day after injury and a significantly higher level of bone alkaline phosphatase on the 90th day after surgery. These patients also had significantly lower levels of urinary C-telopeptide (CrossLaps) on the 15th, 45th and 90th days after injury and lower levels of urinary hydroxyproline on the 15th and 45th days after injury. Patients in group A had significantly higher bone mineral density at all recorded sites except the greater trochanter at three months and one year after operation. After a four-year period of clinical observation, five patients (24%) in group B sustained a new fracture, in four of whom (20%) it was of the contralateral hip.

Our findings show that calcitonin reduces acute bone loss in patients with pertrochanteric fractures and may prevent the occurrence of new fractures of the contralateral hip in the elderly.






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Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General