Журнал «Травма» Том 15, №4, 2014
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Early diagnosis of structural disorders of the functional state of bone fragments in open diaphyseal fractures
Авторы: N.I. Berezka, T.M. Pavlova - Kharkiv National Medical University, Kharkiv, Ukraine; Municipal health care "Regional Hospital - Center for emergency medical care and emergency medicine", Kharkov, Ukraine
Рубрики: Травматология и ортопедия
Разделы: Клинические исследования
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Introduction
Diagnosis and treatment of patients with open fractures at present remains an urgent problem in traumatology and orthopedics. Among all fractures of long bones proportion of open diaphyseal fractures ranges from 28 % to 53 % [2].
This is due to an increase in the severity of the injury and the continuing increase in road traffic injury [1].
Existing objective methods for assessing regional blood flow and tissue metabolism, such as rheovasography, thermography, ultrasound, and others., are important, but not enough to learn the signs of adverse structural and functional state of bone fragments that are essential for further repair process [5].
It is proved that the bone tissue has conductivity ions but substantially lower than the conductivity of other tissues [7].
In our study of many scientific papers we not found determine the electrical bone in open fractures, which in our opinion is irrelevant and requires a study of the issue.
The aim - to develop a method for early diagnosis of structural-functional state of bone in open diaphyseal fractures based on the determination of the electrical resistance, depending on the nature of the injury.
Materials and methods
In our study involved 56 patients with diaphyseal fractures of the extremities. In the analysis of clinical material used classification (AO / ASIF) [5]. To assess the structural and functional state of bone fracture zone using the proposed method for determining the electrical resistance with a multimeter digital UT70B.
Results and discussion
Our studies have shown that exposure effects on bone segment traumatic force of varying intensity is the destruction of the structural-functional state of bone tissue at some distance from the fracture zone. Bone cells, such as osteocytes, undergo morphological changes, leading to disruption of their functional state. Based on the results of the study of the electrical resistance of the cortical layer of bone tissue when exposed to traumatic force of varying intensity on traumatic segment, we have identified areas of ultrastructural changes of bone tissue, namely in terms of electrical resistance from 2500 megohms to 4000 megohms zone of necrosis, in terms of electrical resistance of 1500 megohms 2500 megohms - necrobiosis area, from 800 to 1500 megohms - viable bone. Therefore, we believe that measuring the electrical resistance of bone reflects its electrical conductivity, which is also important for predicting future fracture consolidation process.
Conclusions
Studies have shown to assess the structural and functional state of bone in diaphyseal fractures by determining their electrical resistance in the zone of fracture.
We proposed device multimeter UT70B can objectively evaluate the electrical resistance of bone in areas of damage, which in turn makes it possible to indirectly characterize its viability and predict the processes of bone fusion .
Clinical observation of 56 patients with different types of fractures have shown the feasibility of using this method of measurement of electrical resistance in the areas of bone damage. This was important for selecting treatment and predicting the process of repair and rehabilitation.
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