THE EFFECT OF SHORT-TERM CALCITONIN ADMINISTRATION ON BIOCHEMICAL BONE MARKERS IN PATIENTS WITH ACUTE IMMOBILIZATION FOLLOWING HIP FRACTURE

The effect of salmon calcitonin on changes in mineral metabolism was s tudied in 40 elderly patients with recent hip fracture. All patients u nderwent surgery (internal fixation) 1 week after admission and were r andomly divided into two equal groups: group A, which received no trea tment, and group B, which received 100 IU/day salmon calcitonin intram uscularly for 2 weeks starting on admission. Blood and 24-h urine para meters of mineral metabolism were measured on admission and at the end of weeks 1 and 2. No intra- or intergroup changes in serum calcium, p hosphorus or alkaline phosphatase were observed. At the end of week 2 biochemical markers of bone resorption (urinary calcium and hydroxypro line) had significantly increased in group A and significantly decreas ed in group B, indicating a reduction in bone resorption in group B. U rinary phosphorus had also increased in group B, possibly due to the p hosphaturic effect of calcitonin. It is concluded that immobilization resulting from a hip fracture, and possibly surgery itself, causes sig nificant changes in biochemical markers of bone resorption. Calcitonin successfully reverses these changes and may also be effective in prev enting subsequent bone loss, particularly in patients who cannot be re mobilized immediately.