Post-traumatic changes in insulin-like growth factor type 1 and growth hormone in patients with bone fractures and traumatic brain injury

The aim of the study was to determine whether changes in serum levels of gr owth hormone (GH) and insulin-like growth factor type 1 (IGF-1) are related to the phenomenon of enhanced osteogenesis in patients with bone fracture combined with traumatic brain injury (TBI), which would also suggest their involvement in posttraumatic stress and their applicability in the promotio n of bone fracture healing. GH values were increased during the initial pos t-traumatic period in all patients (those with bone fractures or TBI alone or combined injury associated with enhanced osteogenesis), declining to nor mal values afterwards. However, a further increase in GH was only observed in patients with combined injury overlapping with the time of clinically ma nifested enhanced osteogenesis. Serum levels of IGF-1 were above normal thr oughout the study period (14 weeks) in patients with TBI only, but not if T BI was combined with bone fractures followed by enhanced osteogenesis. In t hese patients IGF-1 values increased gradually during fracture healing, as was also the case in patients with bone fractures alone. Thus, different pa tterns of post-traumatic changes in both GH and IGF-1 were seen in patients with TBI or bone fractures in comparison to those with combined injury, in dicating the involvement of these substances in the posttraumatic stress re sponse and in the phenomenon of enhanced osteogenesis in patients with bone fractures and TBI.