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When monitoring patients recovering from fracture of long bones, adding ALKP to the following visits, provides useful information and might help in determine if the prognosis is good or is the veterinarian must intervene.

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Dogs from groups A and B that were recovery from fractures presented higher serum concentrations of ALKP than dogs in group C that did not form bone callus (Fig.1).

Fractures have high activity of osteoblasts. Those cells release large quantity of ALKP, which can then be regarded as a bone activity biomarker.

In combination with the physical examination and radiography, ALKP serial measurements can be added when monitoring patients recovering from fractures in long bones.

The advantages of the test include low cost, and the test can easily be performed. Additionally, it helps in the prognosis and indicate if early intervention is needed.

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Komnenou et al. (2005) performed a study with 83 dogs that underwent surgery to reduce a fracture in long bones. The patients were divided in three groups:
(A) dogs (n=35) which uncomplicated bone union developed within 2 months;

(B) dogs (n=36) with delayed bone union (3–5 months);
(C) dogs (n=12) in which the fracture healing process was very slow (failed to achieve bone union during a period of 2 months).

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Alkaline phosphatase or ALKP is an enzyme produced by different organs including liver, digestive system, kidneys and bones.
ALKP is part of biochemistry panel and is mainly used to monitor liver damage

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Bone healing is usually monitored by successive radiography and physical examination of the  fractured site. However, non union can not be differentiated from delayed union and the appropriate measures might be delayed.