Correlation Between Peak Transforming Growth Factor Beta 1 Plasma Levels and Early Stage of Radiological Union in Paediatric Supracondylar Humerus Fractures at Kenyatta National Hospital

Abstract

Study Background: Transforming growth factor beta 1 is currently only being evaluated for experimental rather than diagnostic or therapeutic purposes. It plays multiple roles in tumour biology as well as wound and fracture healing. Supracondylar humerus fractures are common paediatric injuries classified and managed according to the Wilkin’s modification of the Gartland’s classification. The purpose of this study was to determine the association between peak plasma level of activeTGFB1 and the stage of radiological union 3 weeks post injury or surgery in patients with paediatric supracondylar humerus fractures. Broad Objective: To determine the association between peak active TGFB 1 plasma level and the stage of radiological union in patients with paediatric supracondylar humerus fractures 3 weeks after injury or surgery. Hypothesis: A higher peak plasma level of TGFB1 does not affect the odds of having a more advanced stage of radiological union in paediatric supracondylar humerus fractures. Materials and Methods: The study was carried out between December 2021 and March 2022 at the Kenyatta National Hospital. An analytical cross sectional study design was employed. 44 patients with paediatric SCHF were recruited using simple random sampling. TGFB1 plasma level was assayed via ELISA while the stage of radiological fracture union evaluated using a pre-designed ordinal scale 21 days after injury or surgery. Statistical Analysis: Descriptive data was analysed using the SPSS© version 24 and presented as means and percentages. Independent samples t test was used to compare means. Ordinal logistic regression was used for hypothesis testing. Results: A total of 44 participants were included in the study. The mean age was 6.8 (s.d. = 2.205) years. The proportion of males to females was 72.72% to 27.27%. Mean peak TGFB1 plasma level was 116.28ng/ml (s.d. = 27.23) with no statistically significant difference between levels in males and females (p = 0.878). There was a xiii significant negative correlation between age and TGFB1 plasma level (r = -0.824) . The odds ratio of having an advanced stage of radiological union with an increased peak plasma level of TGFB1 was 1(p = 0.0869) thus we failed to reject the null hypothesis. Conclusion: An increase in peak active TGFBI plasma level (ng/ml) does not affect the odds of having an advanced stage of radiological union at 3 weeks post injury or surgery in paediatric supracondylar humerus fractures.