A Placebo Control Trial To Assess The Role Of Calcitonin In Early Fracture Healing In Intertrochanteric Fracture Treated Surgically At Tertiary Care Hospital,Belagavi’’

Abstract

INTRODUCTION: Intertrochanteric fracture femur burden is 250,000 annually and indicates a increasing morbidity in old age population in America as well as Globally, they often as a result of trivial injury in the old age patient. These fracture account for the largest morbidity in the old age patient and are usually linked with osteoporosis, hip fracture occurring due to osteoporosis are increasing socioeconomic problem and cause reduced life quality. Intertrochanteric fracture are among commonly operated fracture in the old age patient, they have high post-operative mortality rate leading to prolonged hospitalization and lead to poor recovery of functional independence after conventional fracture care. Calcitonin is used to treat patients with hip fracture because it is a potent inhibitor of bone resorption. Calcitonin decreases pain intensity and promote early mobilization. The present study has been conducted in our hospital which is a tertiary care centre to evaluate the efficacy of Salmon calcitonin in early fracture of intertrochanteric fracture treated surgically. AIMS AND OBJECTIVES: To evaluate the outcome of salmon calcitonin in early fracture healing of intertrochanteric fracture patients treated surgically. MATERIALS AND METHODS: A randomised clinical trial was carried out in KLE’S Dr. Prabhakar Kore Hospital & Medical Research Centre, Belagavi from 1st January 2018 to 31st December 2018 and required data was collected from the 40 patients who underwent surgical fixation for intertrochanteric fracture followed by Salmon calcitonin therapy (Group A) or Placebo therapy (Group B) the outcome was assessed in terms of early fracture union X-RAY of femur full length anteroposterior(AP) and lateral views are taken on 1st week ,6th week and 10th week of post-operative period and compared between each group using Radiographic Union Scale for Hip (RUSH) score. Patients are also assessed for pain at the same time with VAS score. RESULTSand Conclusion: The obtained data was statistically analysed using SPSS software. To compare the rate of fracture healing between the interventional group (Calcitonin group) and the control group (Placebo group) on basis of RUSH score, MANN-WHITNEY TEST was used. The minimum Rush score in interventional group at 1st week is 14 whereas in control group is 12 and maximum score in interventional group is 16 and control group is 14. The minimum Rush score in interventional group at 6th week is 23 whereas in control group is 18 and maximum score in interventional group is 26 and control group is 21. The minimum Rush score in interventional group at 10th week is 30 whereas in control group is 23 and maximum score in interventional group is 30 and control group is 28. This test signifies that the rate of fracture healing assessed using RUSH score at 1st, 6th and 10th in interventional group is significantly more when compared to control group as p value is <0.0001. The intensity pain as calculated by VAS score was compared between the interventional group and the control group on 1st week,6th week & 10th week using MANN-WHITNEY test which showed that the interventional group had a lesser intensity of pain as compared to the control group as showed by the p value which is less than 0.0001. So helping in early mobilization of the patients. In, our study the rate of Fracture healing was faster in the patient treated with Salmon Calcitonin group as compared to Placebo (control) group and the pain intensity was significantly lower in patient treated with Salmon Calcitonin group as compared to placebo group. Thus, we conclude that the rate of fracture healing as assessed using RUSH score was faster showing early fracture union, complete consolidation of fracture and early disappearance of fracture line and reduced intensity of pain in calcitonin treated group.