The Use of Intranasal Calcitonin to Improve Pain and Activity in Elderly Pelvic Ring Injuries
Status:
Recruiting
Trial end date:
2025-12-01
Target enrollment:
Participant gender:
Summary
Pelvic ring fractures in the geriatric population are a rising problem for surgeons in
industrialized countries. Many of these low-energy fractures are treated nonoperatively;
however, pain is a significant factor in recovery of these patients and often inhibits their
ability to mobilize. Most of these fractures are lateral compression type 1 injuries which
are defined as an impaction to the sacrum with varying amounts of anterior/pubic root/rami
fractures. Many of these patients in the geriatric population suffer from osteoporosis and
the injuries are often sustained from a low-energy mechanism like a fall. The tenet of
treatment for all osteoporotic fractures is early mobilization. It is well known that
extended periods of bed rest will lead to pneumonia, decubitus ulceration, deep venous
thrombosis, and, in the case of the pelvis, not prevent subsequent deformity. Calcitonin is a
polypeptide containing 32 amino acids, and it plays a role in the regulation of bone
metabolism as a hormone that prevents bone resorption. Intranasal salmon calcitonin (ISC) has
been demonstrated to decrease pain and improve the level of activity in patients with acute
vertebral osteoporotic compression fractures when administered within the first 5 days of
onset of pain/injury. It has also demonstrated an immediate post analgesic effect in
osteoporotic distal radius fractures treated nonoperatively. The antihyperalgesic action of
calcitonin appears to be mediated by serotonin receptors. The purpose of this study is to
evaluate the analgesic effect of ISC on geriatric patients with pelvic ring injuries who are
treated nonoperatively.