Clinical evaluation of fracture healing by serum osteocalcin and alkaline phosphatase.

The serum osteocalcin (BGP) concentration and alkaline phosphatase (AP) activity were measured prospectively during the healing phases of crural fractures in 15 patients. They were divided into two groups, the time of union of the fracture being under (group 1) or over 16 weeks (group 2). The mean values of BGP and AP were somewhat higher from the outset in the group 1 than in the group 2, but the difference was not significant. A significant increase in BGP and AP (P less than 0.05) was evident in both groups at 6 weeks. In cases with undisturbed healing of fractures (group 1) the values of serum BGP and AP then declined towards the values at the time of accident. Contrary to this, in group 2 both the values of the serum BGP and AP were still at a significantly higher level than those at the day of the fracture. However, no significant difference in the serum BGP or AP was seen between the two groups at 6 or 12 weeks. The results support some earlier ones: the changes in serum BGP and AP may provide a prognostic indicator for consolidation of a fracture.