Clinical calcium
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Fracture may influence the serum and urine levels of bone turnover markers, however, the changes in bone markers seem to be not constant. The magnitude of change may be dependent on the size of the fractured bone, the amount of bone involved, and difference in bone markers. ⋯ Bone formation markers peaked later than bone resorption markers and remained elevated up to 1 year after fracture. This elevation in bone turnover markers reflects the repair process after fracture, and also immobilization following fracture, bone loss close to the fracture, and post-traumatic systemic reactions contribute to the accelerated bone formation and resorption.
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Review
[Bone fracture and the healing mechanisms. Fracture treatment by low-intensity pulsed ultrasound].
The principles of fracture treatment are the reduction and fixation of the fracture site, while the subsequent biological healing process is expected. Currently, some treatment options that actively stimulate the repair reaction at the fracture site are either available, or they are soon going to become available for clinical use. ⋯ They are non-invasive or less invasive than the previous stimulating options such as bone grafting at the fracture site. These treatment modalities are not only used to heal delayed union or non-union but they also have the potential to shorten the repair period until union is achieved while also reducing complications, including deformity or non-union.
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The distal radius is one of the most commonly fractured long bone. Colles' fracture results from a fall on the dorsiflexed and pronated hand. The dinner-fork deformity is the typical deformity of the Colles' fracture. ⋯ The non-bridge type external fixator is applied for patients without an intra articular fracture. For patients with a comminuted fracture, the locking plate (volar approach) is recommended. During the healing period, shoulder, elbow and finger exercise should be insisted.
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Calcitonin is a polypeptide hormone that bone resorption-inhibitory and analgesic effects, and has been used over many decades as a drug for the treatment of osteoporosis in Japan and overseas. Reports of large-scale studies of this hormone therefore as yet are few, compared to recently introduced drugs. ⋯ A mechanism of action involving its serotonin receptor expression-mediated effect on pain impulse transmission has been demonstrated. On account of this effect, calcitonin is recommended for use in the management of pain in patients with fresh vertebral fractures.
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The loss of bone mineral due to space flight or prolonged bed rest has been recognized by space scientists and physicians. In spite of the wealth of knowledge obtained thus far, many questions remain unanswered regarding the mechanism of bone loss as well as the factors affecting these skeletal processes. Bisphosphonates have a potential to become countermeasures against space flight-induced or disuse osteoporosis. In this review, the effect and the possible role of biphosphonates on the prevention and treatment of unloading-induced osteoporosis are summarized and future prospects are discussed.