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Research article
Katharina Blanka Dr. Jäckle
Georg-August-Universitat Gottingen Universitatsmedizin
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3086-4278
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
The skeletal disease osteoporosis affects primarily postmenopausal women. It is characterized by increased fracture risk due to defective remodeling of bone tissue and a pathological bone microarchitecture in response to the decreased levels of estrogen. Osteoporosis is clinically silent up until a first fracture occurs. Therefore, the diagnosis of the disease is usually late. Recent preclinical studies with mice, rats and rabbits suggested that estrogen treatment enhances the healing effect after bone fractures. Here we asked whether transdermally applied estrogen, which restores the systemic premenopausal level of estrogen, has a beneficial effect on fracture healing of postmenopausal women as observed in preclinical models.
Methods
To investigate whether estrogen has a beneficial effect on bone fracture healing of postmenopausal patients, we performed a prospective double-blinded randomized study with 76 patients suffering from distal radius fractures. A total of 31 patients (71.13 years ± 11.99) were treated with estrogen and 45 patients (75.62 years ± 10.47) served as untreated controls. Calculated bone density as well as cortical bone density were determined by peripheral quantitative computed tomography (pQCT) prior to and six weeks after the surgery.
Results
We found that unlike with preclinical models, bone fracture healing of human patients was not improved in response to estrogen treatment. Furthermore, we observed no dependence between age-dependent bone tissue loss and constant callus formation in the patients.
Conclusions
Transdermally applied estrogen to postmenopausal women, which results in estrogen levels similar to the systemic level of premenopausal women, has no significant beneficial effect on bone fracture healing.
Keywords
estrogen, fracture healing, osteoporosis, callus formation
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CURRENT STATUS: Published
View the published article at BMC Musculoskeletal Disorders.
No community comments so far
Editorial decision: Accept
On 09 Oct, 2020
Editor assigned
On 05 Oct, 2020
Submission checks complete
On 04 Oct, 2020
Editor invited
On 04 Oct, 2020
No comments provided
Reviewers invited
Invitations sent on 05 Aug, 2020
Reviewer #1 agreed
On 05 Aug, 2020
Review #1 received
Received 05 Aug, 2020
Editor assigned
On 03 Aug, 2020
Submission checks complete
On 02 Aug, 2020
Editor invited
On 02 Aug, 2020
Version 1
Posted 01 Jun, 2020
No comments provided
Editorial decision: Major revision
On 22 Jul, 2020
Review #3 received
Received 21 Jul, 2020
Review #2 received
Received 13 Jul, 2020
Reviewer #3 agreed
On 01 Jul, 2020
Reviewer #2 agreed
On 29 Jun, 2020
Review #1 received
Received 09 Jun, 2020
Reviewer #1 agreed
On 08 Jun, 2020
Reviewers invited
Invitations sent on 03 Jun, 2020
Editor assigned
On 22 May, 2020
First submitted
On 21 May, 2020
Submission checks complete
On 21 May, 2020
Editor invited
On 21 May, 2020
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Subject Areas
Orthopedics
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Musculoskeletal Disorders.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Katharina Blanka Dr. Jäckle
Georg-August-Universitat Gottingen Universitatsmedizin
Corresponding Author
ORCiD: https://orcid.org/0000-0002-3086-4278
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Musculoskeletal Disorders.
No community comments so far
Editorial decision: Accept
On 09 Oct, 2020
Editor assigned
On 05 Oct, 2020
Submission checks complete
On 04 Oct, 2020
Editor invited
On 04 Oct, 2020
No comments provided
Reviewers invited
Invitations sent on 05 Aug, 2020
Reviewer #1 agreed
On 05 Aug, 2020
Review #1 received
Received 05 Aug, 2020
Editor assigned
On 03 Aug, 2020
Submission checks complete
On 02 Aug, 2020
Editor invited
On 02 Aug, 2020
Version 1
Posted 01 Jun, 2020
No comments provided
Editorial decision: Major revision
On 22 Jul, 2020
Review #3 received
Received 21 Jul, 2020
Review #2 received
Received 13 Jul, 2020
Reviewer #3 agreed
On 01 Jul, 2020
Reviewer #2 agreed
On 29 Jun, 2020
Review #1 received
Received 09 Jun, 2020
Reviewer #1 agreed
On 08 Jun, 2020
Reviewers invited
Invitations sent on 03 Jun, 2020
Editor assigned
On 22 May, 2020
First submitted
On 21 May, 2020
Submission checks complete
On 21 May, 2020
Editor invited
On 21 May, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Orthopedics
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Musculoskeletal Disorders.
Background
The skeletal disease osteoporosis affects primarily postmenopausal women. It is characterized by increased fracture risk due to defective remodeling of bone tissue and a pathological bone microarchitecture in response to the decreased levels of estrogen. Osteoporosis is clinically silent up until a first fracture occurs. Therefore, the diagnosis of the disease is usually late. Recent preclinical studies with mice, rats and rabbits suggested that estrogen treatment enhances the healing effect after bone fractures. Here we asked whether transdermally applied estrogen, which restores the systemic premenopausal level of estrogen, has a beneficial effect on fracture healing of postmenopausal women as observed in preclinical models.
Methods
To investigate whether estrogen has a beneficial effect on bone fracture healing of postmenopausal patients, we performed a prospective double-blinded randomized study with 76 patients suffering from distal radius fractures. A total of 31 patients (71.13 years ± 11.99) were treated with estrogen and 45 patients (75.62 years ± 10.47) served as untreated controls. Calculated bone density as well as cortical bone density were determined by peripheral quantitative computed tomography (pQCT) prior to and six weeks after the surgery.
Results
We found that unlike with preclinical models, bone fracture healing of human patients was not improved in response to estrogen treatment. Furthermore, we observed no dependence between age-dependent bone tissue loss and constant callus formation in the patients.
Conclusions
Transdermally applied estrogen to postmenopausal women, which results in estrogen levels similar to the systemic level of premenopausal women, has no significant beneficial effect on bone fracture healing.
Figure 1
Figure 2
Figure 3
Figure 4
This is a list of supplementary files associated with this preprint. Click to download.
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