Mechanism-dependent kinetics of bone remodeling and inflammatory markers after combined maxillofacial trauma

Severity scores and imaging describe how much of the facial skeleton is broken, but say little about the biological response that governs repair. Whether this response differs with the mechanism of injury has not been examined in combined maxillofacial trauma. To compare the early post-traumatic kinetics of bone-turnover, inflammatory, and mineral-metabolism markers across four injury mechanisms and to relate them to clinical severity. Patients with combined maxillofacial injuries were divided into four groups by mechanism: road traffic accidents (RTA), falls from height, sports injury, and multifactorial trauma. Severity was scored with the Facial Injury Severity Scale (FISS) and the Comprehensive Facial Injury (CFI) score. Ten patients per group underwent serum sampling on days 1, 3, 5, 10, and 14 after injury for C-terminal telopeptide of type I collagen (CTX), tartrate-resistant acid phosphatase 5b (TRAP5b), osteocalcin, alkaline phosphatase (ALP), interleukin-6 (IL-6), C-reactive protein (CRP), parathyroid hormone (PTH), calcium, phosphorus, and vitamin D. CFI was highest after RTA (12.8±4.6) and multifactorial trauma (11.5±4.2) and lowest after sports injury (6.2±2.4; p