Objective: To investigate the expression and value of bone specific alkaline phosphatase(BSAP), N-MID osteocalcin(N-MID), N-propeptide of type 1 collagen(P1NP), β-crosslaps in patients with delayed union of traumatic fracture. Methods: From January 2016 to June 2018, 84 cases of delayed union of tibial shaft fracture(delayed union group) and 60 patients with normal healing of tibial shaft fractures(normal union group) were selected. The levels of BSAP, N-MID, P1NP and β-crosslaps were compared between the two groups at 1, 4, 8 and 12 weeks after fracture. Logistic regression was used to analyze the influencing factors of delayed union.ROC curve was used to analyze the value of bone turnover index in predicting delayed union, and AUC was calculated. Results: There was no significant difference in serum BSAP, N-MID, P1NP and β-crosslaps between the two groups at 1 week after fracture(P>0.05).The serum levels of BSAP,N-MID,P1NP in the delayed union group were lower than those in the normal union group at 4,8 and 12 weeks after fracture(P<0.05). There was no significant difference in β-crosslaps levels between the two groups at different time points(P>0.05). Postoperative infection and the expression levels of BSAP, N-MID and P1NP at 4 weeks after fracture were independent factors affecting delayed fracture union(P<0.05). The AUC of serum P1NP,BSAP,N-MID predicting delayed union at 4 weeks after fracture were 0.897,0.843,0.790 respectively, combined detection could increase the AUC to 0.916. Conclusion: Serum levels of BSAP, N-MID and P1NP have certain value in early prediction of delayed union of traumatic tibial shaft fractures. |
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