Value of markers of bone tissue resorption in the prognosis of development of slow consolidation of fractures of long bones of extremities

The objective of the work was to study value of indicators of pyridinoline and dezoksipyridinoline in the prognosis of development of slow consolidation of fractures of long bones of extremities. We carried out the research of markers of resorption of bone tissue in 75 patients of 16-55 years with fractures of long bones of extremities in postoperative period. The first group included. 44 patients with non-complicated course of posttraumatic period. The second group (n = 31) included patients with disorder of consolidation of fractures in late posttraumatic period (slow consolidation). Control group included. 30 nearly healthy people of 18-35 years. Groups of patients were compared by sex, age, time of getting the injury, character of fractures and. the treatment they got. The criteria of excluding out of the research were patients with any concomitant pathology and. also women in menopause. The researches were realized on the 2^nd and. the 10^th day of posttraumatic period. Statistical processing of the data was realized with help of «BIOSTAT». The analysis of data between the groups of patients in different terms of posttraumatic period was carried out with, help of Newman - Keuls criteria. To compare indices of patients with, complicated and. non-complicated. course of fractures of long bones of extremities we used Mann - Whitney criteria. The differences were considered statistically sigificans at p < 0,05. It was determined that at the level of pyridinoline in blood serum more than 15 % and of deoxypyridinoline in urine more than 35 % of control values on the 10^th day after trauma the disorder of consolidation of fractures in late postoperative period is prognosed. Determination of indices of pyridinoline and. deoxypyridinoline patients with fractures of long bones of extremities on the 10th day of posttraumatic period allows to prognose development of slow consolidation of fractures that can allow to realize preventive prophylactic and. treatment measures aimed at precaution of development of disorders of consolidation.

fractures of long bones of extremities, consolidation disorder, prognosis

1. Барабаш Ю.А., Барабаш А.П., Балаян В.Д. и др. Интрамедуллярный остеосинтез с блокированием в лечении больных с псевдоартрозами длинных костей // Илизаровские чтения: Матер. науч.-практ. конф. с междунар. участием (Курган, 14 - 15 июня 2012). - Курган, 2012. - С. 56 - 57.

2. Кесян Г.А. и др. Сочетанное применение обогащенной тромбоцитами аутоплазмы и биокомпозиционного материала Коллапан в комплексном лечении больных с длительно несрастающими переломами и ложными суставами длинных костей конечностей // Вестн. травмат. и орт. - 2011. - № 2. - С. 26 - 32.

3. Кузник Б.И., Лиханов И.Д., Цепелев В.Л. и др. Теоретические и клинические аспекты биорегулирующей терапии в хирургии и травматологии. - Новосибирск: Наука, 2008. - 311 с.

4. Мамаев В.И. Оптимизация хирургического лечения последствий переломов костей с использованием прогностических алгоритмов: дис.. докт. мед. наук: 14.01.15. - Курган, 2010. -243 с.

5. Мироманов А.М., Герасимов А.А., Намоконов Е.В. Современные подходы к классификации переломов длинных костей конечностей // Вестн. эксперимент. и клин. хир. - 2011. - № 4. - С. 760 - 763.

6. Мироманов А.М., Усков С.А. Способ прогнозирования нарушения регенерации костной ткани при переломах длинных костей конечностей в послеоперационном периоде // Гений ортопедии. - 2011. - № 4. - С. 26 - 30.

7. Решетников А.Н. Оптимизация лечения больных с ложными суставами и дефектами длинных костей нижних конечностей (клиникоэкспериментальное исследование): автореф. дис. докт. мед. наук. - Самара, 2005. - 41 с.

8. Риггз Б.Л., Мелтон Л.Дж. Остеопороз (этиология, диагностика, лечение): пер. с англ. / Под ред. Е.А. Лепарского. - М.: БИНОМ -Симферополь: AZ-PRESS - СПб.: Невский Диалект, 2000. - 560 с.

9. Chen Y.H., Wu Y.W., Yang W.S. et al. Osteoporosis treatment in postmenopausal women with pre-existing fracture // Taiwan J. Obstet. Gynecol. - 2012. - Vol. 51 (2). - P. 153 - 166.

10. Delia M. Pseudartrosis with bone loss in femur and tibia // World Congress on External fixation: Papers Book (Peru, Lima, May 26 - 28, 2005). - Lima, 2005. - Р. 39.

11. Delmas P.D., Eastell R., Garnero P. et al. For the Committee of Scientific Advisors of the International Osteoporosis Foundation. The use of biochemical markers of bone turnover in osteoporosis // Osteoporosis International. - 2000. - Vol. 6. - P. 2 - 17.

12. Donal A.L., Moniz C., Abraha H., Pitt P. Does active treatment of rheumatoid arthritis limit disease-associated bone loss? // Rheumatology. -2002. - Vol. 41 (9). - P. 1047-1051.

13. Looker A.C., Bauer D.C., Chesnut C.H. et al. Clinical use of biochemical markers of bone remodeling: current status and future direction // Osteoporosis Int. - 2000. - Vol. 11, N 6. - P. 467 - 480.

14. Muller M.E., Nazarian S., Koch P., Schtzker J. The comprehensive classification of fractures of long bones. - Heidelberg - New York: Springer-Verlag, 1996. - 32 р.

15. Ristelli J., Elornaa I., Niemi S. et al. Radioimmunoassay for the pyridinoline cross-linked carboxy-terminal telopeptide type 1 collagen: a new serum marker of bone collagen degradation // Clin. Chem. - 1993. - Vol. 39. - P. 635 - 640.