Hydroxyproline for the Assessment of Fracture Union

Fractures are common orthopaedic problem and it occurs most in long bones. Amongst all long bones, shaft of tibia is one of the commonest bones that are prone to fractures. Such fractures have relatively higher incidence of impaired healing as the fracture site has lesser soft tissue coverage, because of subcutaneous bone on anterior aspect. The mentioned reasons account for a high rate of tibial non-unions amounting to 2 10% of all tibial fractures which leads to significant patient morbidity. Non-union fracture is a dreaded complication with devastating outcomes for the patients. Most of the time, a complex and expensive treatment are required involving multiple surgical procedures, pain, morbidity, prolonged hospital stay and functional and psychosocial disability. The implementation of treatment protocols for such clinical situation can be complex and long-lasting. Moreover, the consequent socio-economic burden on patients and then families should not be underestimated. Ability in prompt identification of patients who are at high risk of non-union will enable early appropriate targeted treatment intervention leading to a successful outcome. Such approach would benefit not only the patient’s wellbeing but also the health care system in terms of the cost implications associated with long lasting treatment interventions and prolonged hospital stay. Abstract