SU1636769A1 - Method for long tubular bone fracture healing course prediction - Google Patents

Abstract

This invention relates to medicine and relates to methods for predicting complications in fractures of long tubular bones. The aim of the invention is to improve the accuracy and simplify the method. To achieve the goal, 2–60 days and later after the fracture, the acid-forming function of the stomach is determined and, if it is reduced, they predict a slower healing, and when an anacid state is predicted, a false joint is predicted. The accuracy of the proposed method is 96%. 1 tab.

Description

The invention relates to the field of medicine and relates to methods for predicting complications in fractures of long tubular bones.

The aim of the invention is to improve the accuracy and simplify the method

The method is carried out as follows.

For 2-3 days after the fracture in patients examine the acid-forming function of the stomach with the diagnostic tool Atsidotest. To do this, after emptying the bladder, patients are given 1-2 tablets of caffeine and after 1 hour they collect urine (control). After that, patients take 3 test dragees with a small amount of water. After 1.5 hours, the urine is collected again. The studied urine is diluted with water to 200 ml, to 5 ml of diluted urine 5 ml of 25% hydrochloric acid is added, and the condition is determined by the color scale.

gastric secretion. Under normal conditions, secretion of fractures is predicted at normal times, with a hypoacid - delayed consolidation, with anacid, with the formation of a false joint. The study can be performed at a later date after the fracture, since the changes observed last for 1-2 months or more after the fracture. The table presents the dependence of the prediction accuracy on the period for determining the acid-forming function of the stomach after a fracture.

Example 1. Ill E., 43 years. Delivered to the casualty department with a diagnosis of a closed oblique fracture of both bones of the left tibia in the middle third with a shift of fragments in width and length. Upon admission to the hospital, swelling, cutting pain, crepitus fragments, and pathological progress (L

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ness in the middle third of the left tibia. After confirming the diagnosis by X-ray examination, skeletal stretching was applied to the handbelling area. On the 3rd day after the fracture, the acid-forming function of the stomach was studied with the help of Acidotest and normal acidity of the gastric juice was determined. Taking into account the data obtained, it was concluded that the normal course of reparative processes in the bone tissue and the fracture fusion in the usual terms.

Clinically, consolidation of the bones of the tibia occurred 20 days after the fracture, as evidenced by the disappearance of the fracture of the fragments, abnormal mobility in the middle third of the tibia after the removal of skeletal extension. Radiographically after 20 days, the formation of a good primary callus connecting the ends of bone fragments is noted. After removal on the 20th day of skeletal stretching, the left lower extremity was immobilized with a circular plaster cast. The complete accretion of fragments of the bones of the tibia occurred on the day when the callus was determined radiographically, the complete accretion of bone fragments with the disappearance of the fracture line.

Temporary disability was 110 days.

Example 2. Patient B., 53 years old. Delivered to the clinic with a diagnosis of a closed comminuted fracture of the lower third of both bones of the right tibia with fragments displaced in width and length. After the clinical and X-ray examination and confirmation of the diagnosis, the patient underwent a skeletal extension for the heel bone. On the 3rd day after the fracture, the acidity of the gastric juice was examined and the reduced acid-producing function of the stomach was determined. Predict slow fracture fusion. Conservative treatment was unsuccessful. On the 18th day, the Ilizarov apparatus was superimposed on the right lower leg of the patient. The maturation period was 217 days, temporary disability - 247 days.

Example 3. Patient K „, 20 years old. He was admitted to the hospital with a diagnosis of a closed fracture of the middle third of the right.

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tibial bone with displacement of fragments in width and length. The diagnosis is confirmed radiologically. The patient underwent skeletal stretching over the supra-supine region and the limb was laid on the Beller splint. On the 3rd day, the anacid state of gastric secretion was diagnosed using the Acidotest and a prognosis on the formation of a false joint was made. Skeletal stretching was carried out for 35 days and after it was put on a plaster cast. After 140 days, the control examination of the elements of the callus is not detected, and after removing the patch, pathological mobility is determined. The Ilizarov apparatus was applied to the right calf. Despite the compression of the fragments 10 months after the application of the Ilizarov apparatus, the fracture of the middle third of the right calf was determined X-ray, the bone marrow channels were closed. The patient had a false joint, which corresponded to the prediction.

Example 4. Ill S., 69 years. It was admitted with a diagnosis of closed comminuted fracture of both bones of the right tibia in the lower third with displacement of fragments in width at an angle. After confirming the nature of the fracture of the radiologically patient, skeletal stretching was imposed on the bone, and on the 3rd day after the fracture, the acid-forming function of the stomach was investigated using the Atsidotest diagnostic tool. The hypocidal state of gastric secretion was revealed in the patient. In order to normalize gastric secretion, the patient was additionally prescribed pepsidyl solution, 1 tablespoon after meals 3 times a day for 60 days, on the 13th day after the fracture An open comparison of fragments, osteosynthesis with screws and immobilization by longuets was carried out.Clinical fracture occurred on the 84th day, which was confirmed radiographically: the formation of callus and the disappearance of the fracture line. Temporary disability was 112 days.

The prediction accuracy of the proposed method is 96%. The method allows early identification of possible bone consolidation disorders and the pathogenetically substantiated correction. The proposed method is much simpler known, since it does not require expensive reagents and equipment, and the study can be performed in a short time.

Claims (1)

Invention Formula A method for predicting the course of healing of fractures of long tubular bones by clinical and laboratory examinations, characterized in that, in order to improve accuracy and simplify the method, the acid-forming function of the stomach is determined 2–60 days and later after the fracture it is predicted to slow healing, in an anacid state, the formation of a false joint is predicted. ten five 1 2 3 4 5 or more 23 20 82 27 30 60 92 96 96 96