RU2283043C1 - Method for treating defects of tubular bones - Google Patents

Abstract

FIELD: medicine, traumatology, orthopedics.

SUBSTANCE: defects of tubular bones should be filled with a transplant, moreover, as a transplant it is necessary to apply autologous thrombocyte-rich plasma at addition of autologous trabecular bone. Then the bone should be fixed. The innovation excludes the application of foreign tissue, shorten therapy terms and decrease the quantity of transplant's detachments in patients.

EFFECT: higher efficiency of therapy.

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Description

The invention relates to medicine, namely to traumatology and orthopedics.

A known method of replacing a bone defect, a description of A. with. No. 1822754 A1, IPC A 61 B 17/56 of 1/13/89, bulletin No. 23 of 06/23/93, ed. N.G. Nikolayeva, L.V. Prokopova, V.S. Astakhova, in which the defect is filled with filler impregnated with autologous bone marrow in order to reduce the treatment time by accelerating the formation of bone regenerate; the bone marrow is preliminarily subjected to ultraviolet radiation, and bone chips (analogue) are used as filler.

Disadvantages: bone marrow sampling, which is an additional traumatic intervention, the use of integrated ultraviolet radiation, which leads to the destruction of intracellular structures, the use of foreign material / allogeneic bone chips /, which is one of the causes of postoperative complications, which leads to an overall increase in costs.

The closest solution from the known is a method of treating bone defects, a description of A. with. No. 1400616, IPC A 61 17/56 dated 03/31/87, bulletin No. 21, dated June 7, 88, where the treatment of bone defects was performed by removing the changed tissues, filling the defect with a bone fixation transplant, characterized in that for the purpose To accelerate the formation of bone regenerate, a porous framework filled with autologous bone marrow fibroblasts with a concentration of at least 10 ⁷ cells in 1 cm ³ grown in culture / prototype / is used as a graft. Disadvantages: this method is traumatic, because bone marrow sampling is performed in the operating room and requires trepanation of the ilium, which is an additional traumatic intervention, requires the use of synthetic culture media, which significantly increases the cost of treatment and the time required for treatment / two to three weeks /, requires an alien / allogeneic / spongy bone material, as well as the use of expensive laboratory equipment and materials for growing colonies of stromal fibroblasts.

Effect: reducing treatment time by reducing the time of preoperative preparation and preventing postoperative complications by eliminating foreign material, which is solved by the fact that the tubular bones are treated by filling the defect with graft and fixing the bone, and an autologous cancellous bone with the addition of autologous is used as a graft platelet rich plasma (BTP), and this reduces the treatment time by reducing the time for preoperative preparation, i.e. the exclusion of growing a culture of fibroblasts with their subsequent passage compared to the prototype, as well as the exclusion of the use of foreign tissue / allogeneic bone spongy matrix /, which leads to a decrease in the number of transplant rejections as one of the types of postoperative complications / in the prototype / and suppuration, and in the proposed method an autologous platelet-rich plasma (BTP) is used, obtained in a much shorter time from the blood of the patient himself using standard equipment.

Example.

Patient K., a liquidator of the Chernobyl accident, 40 years old, was hospitalized in the clinic for an extensive / up to 100 cm ³ / post-traumatic defect in the lower third of the tibia. Surgical intervention was performed - ostiosynthesis of a multi-fragmented fracture of the lower third of both lower leg bones with plates and screws. The defect formed at the time of the injury is an open fracture filled with an autologous cancellous bone taken from the tuberosity of the right tibia with the addition of 70 cm ^{3 of} autologous BOT / platelet-rich plasma /, which was obtained by centrifugation in a clinical laboratory and includes 800-850000 platelets in 1 μl The wound is stitched tightly, a plaster cast was applied.

At the control examination after two months - X-ray formation of a shadow of bone regenerate. The patient did not present complaints, was left without immobilization, walks with an incomplete load.

Thus, clinical and experimental data indicate that the proposed method has significant advantages over the applied / prototype / method for treating defects of tubular bones. The application of the proposed method in comparison with the prototype provides a pronounced clinical positive effect in a significantly short time and eliminates the use of foreign tissue, leads to a speedy recovery of the patient with virtually no complications after surgery.

Technical and economic indicators

Compared with the prototype, the preliminary preparation time before the operation is reduced many times, and as a result of the operations, no complications were observed.

Claims (1)

A method for treating defects of tubular bones by filling a defect with a graft, fixing a bone, characterized in that an autologous platelet-rich plasma with the addition of an autologous cancellous bone is used as a graft.