Dynamics of bone tissue metabolism in the complex treatment of chronic posttraumatic osteomyelitis of long bones

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Abstract


Introduction: Chronic post-traumatic osteomyelitis is a complex problem of modern traumatology and orthopedics, affecting, in addition to medical, social and economic aspects of healthcare. When planning treatment, it is necessary to take into account the metabolic state of the bone tissue, since the effect of an infectious pathogen goes far beyond the “classical” lytic process, disrupting the balance of bone formation and bone resorption in various ways. The study is devoted to the study of the dynamics of parameters reflecting the metabolism of bone tissue in patients receiving complex therapy for chronic post-traumatic osteomyelitis of long bones.

Aim: To study the dynamics of metabolic disorders of bone tissue in patients with orthopedic infection of long bones and large joints under conditions of ongoing complex etiotropic and compensatory therapy for 6 months, the timing of bone tissue consolidation — within 2 years from the moment of surgery.

Materials and methods: The study was prospective, observational, comparative, exploratory, involving 138 patients with post-traumatic chronic osteomyelitis of the long bones. Complex therapy included a combination of surgical treatment with antibacterial, anti-inflammatory therapy and drug correction of the revealed disorders of bone metabolism. The timing of the consolidation of bone defects after treatment and the dynamics of indicators of bone metabolism were studied.

Results: The similarity of the periods of consolidation of different segments in the conditions of the described therapy was shown; the time period corresponding to the most pronounced dynamics of changes (correction) of violations was determined (3 months from the beginning of treatment); shows the effectiveness of metabolic therapy for the treatment of osteoarticular infections in various anatomical segments of the extremities. The results corresponds both to the results of the previous study and to the pathophysiological aspects of bone metabolism described in the literature.

Conclusion: the timing of consolidation in the treatment of metabolic disorders is generally similar; the greatest changes in the parameters of bone metabolism are recorded within 3 months after the start of therapy. Also, the metabolic therapy regimen can be considered as universal for all segments.


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About the authors

Archil V. Tsiskarashvili

Priorov National Medical Research Center of Traumatology and Orthopedics

Author for correspondence.
Email: archil.tsiskarashvili@gmail.com

Russian Federation, Moscow

MD, Cand. Sci. (Med.), traumatologist-orthopedist of the highest qualification category, Head of the department of the consequences of injuries of the musculoskeletal system and purulent complications

Svetlana S. Rodionova

Priorov National Medical Research Center of Traumatology and Orthopedics

Email: centrosteoporoza@gmail.com

Russian Federation, Moscow

MD, PhD, Dr. Sci. (Med.), Professor, Head of the Osteoporosis Center

Sergey P. Mironov

Priorov National Medical Research Center of Traumatology and Orthopedics

Email: armed05@mail.ru

Russian Federation, Moscow

MD, PhD, Dr. Sci. (Med.), Professor, Academician of the Russian Academy of Sciences, Honorary President

Dmitry S. Gorbatyuk

Priorov National Medical Research Center of Traumatology and Orthopedics

Email: gorbatyukds@cito-priorov.ru

Russian Federation, Moscow

researcher of the department of the consequences of injuries of the musculoskeletal system and purulent complications

Alexander Yu. Taraskin

Priorov National Medical Research Center of Traumatology and Orthopedics

Email: aletr2009@yandex.ru

Russian Federation, Moscow

postgraduate student of the department of the consequences of injuries of the musculoskeletal system and purulent complications

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