Author(s): Fathy G Khallaf, Elijah O Kehinde, Sundus Hussein, Sameh I Al Shinawy
In this prospective controlled study, blood samples were withdrawn from 52 patients with head injury, 50 patients with head injury and associated long bone fractures, 60 patients with long bone fractures only, and 50 healthy subjects. Samples were collected: one day, three days, one week, two weeks, and three weeks after the injury and tested for growth factors Insulin growth factor- II (IGF- II); platelet derived growth factor (PDGF), vascular endothelial growth factor (VEGF), Activin-A trans- ferring growth factor β, and Cytokine Interleukin-1 (IL-1). The results of the study showed that Long bone fractures with head injury heal more expectedly, faster and with exuberant callus (P=0.001) and demonstrated that levels of PDGF, VEGF, Activin-A were persistently high with statistical significance during the 3 weeks of follow-up in head injury patients with associated long bone fractures (P=0.004). IGF-II showed statistically significant subnormal level along the whole follow-up period in the same patients (P=0.001). IL-1 cytokine showed initial elevation in the first two weeks then, declined to normal levels at the end of the period of follow-up (P=0.003). We concluded that long bone fractures in head injury patients heal more expectedly, faster, and with exuberant and florid callus formation and growth factors IGF-II, PDGF, VEGF, Activin- A, and cytokine IL- I have roles as mediators, molecular events and by-products of the subtle mechanism of accelerated osteogen - esis in head injury patients with associated long bone fractures and may represent therapeutic potentials to serve as agents to enhance bone repair.