GH in patients with tibial fracture

Growth hormone (GH) plays an important role in bone remodelling due to its stimulatory effect on osteoblast cells. In this paper, Raschke et al studied the safety and efficacy of using GH in the healing of tibial fractures. Currently, surgery for these fractures often results in slow healing time and even non-union in some cases. A total of 368 patients (75% male) completed the trial, which tested 15, 30 and 60ug/kg/day GH doses against placebo for both open and closed fractures (29 and 71% respectively). Treatment commenced 3 days post-surgery and continued for 16 weeks or until healed, whichever was sooner. Both radiological and clinical evaluations were performed until a year after surgery. The author’s results indicate that GH does not accelerate total healing time when both strata are considered. However, if closed fractures are considered separately, a significant difference was seen between treatment groups, with the most noticeable acceleration of healing shown in the 60ug/kg/day GH treatment group. Furthermore, it seemed to be more effective in women. The trial raised no new safety issues for GH and suggests that it may be useful for patients with closed tibial fractures. Effects of growth hormone in patients with tibial fracture: a randomised, double-blind, placebo-controlled clinical trial Raschke M, Rasmussen MH, Govender S, Segal D, Suntum M and Christiansen JS EJE 156-3 DOI: 10.1530/EJE-06-0598