Laboratory criteria for pathological process monitoring in patients with chronic osteomyelitis of the lower leg at the stages of restorative treatment

Abstract

Purpose Search for laboratory criteria of pathological process monitoring in patients with chronic osteomyelitis of the tibia at the stages of its management using the method of transosseous distraction osteosynthesis. Materials and methods Biochemical parameters of blood serum were studied in 15 patients with chronic posttraumatic osteomyelitis of the tibia. Sequester necrectomy with subsequent osteosynthesis of the tibia with the Ilizarov apparatus was performed in all patients at the first stage. At the second stage, the defect was filled in with distraction regenerate according to Ilizarov. Depending on the bone defect size, the patients were divided into two groups. The defect size was from 3 to 5 cm in patients of the first group (n = 7, mean age 42.4 ± 6.9 years). In the patients of the second group (n = 8, mean age 37.5 ± 7.8 years) the size of the defect was from 7 to 12 cm. Results It was found that the changes in the activity of the bone isoenzyme of acid phosphatase (TRAP), alkaline phosphatase, creatine phosphokinase, lactate and C-reactive protein (CRP) did not differ significantly between the groups during their treatment. At the same time, the concentration of CRP, sialic acids and the activity of TRAP in the first stage perids of treatment was significantly increased in patients of both groups relative to the reference norm. In patients of the second group, the concentration of sialic acids was higher than the values of group 1 and the reference group in the periods of 7-21 days of fixation. Nevertheless, at the beginning of the second stage of treatment (distraction), the level of all the studied parameters was not significantly different from the norm. Conclusion Normalization of TRAP activity, concentration of CRP and sialic acids values can be attributed to additional diagnostic features on the basis of which it is possible to start the second stage of treatment (distraction) in patients with chronic osteomyelitis of the tibia.