SU1651211A1 - Method for prognostication of post-traumatic osteomyelitis development - Google Patents

Abstract

This invention relates to medicine, in particular to traumatology. The aim of the invention is early prediction. For this purpose, the concentration of free hydroxyproline and iron is determined daily in the patient's serum and with values of these parameters above 1.5 + 0.1 µg / ml and 6.3 ± +1.8 mmol, respectively, during the first 5 days from the moment of receipt injuries predict the development of post-traumatic osteomyelitis. The method is relatively simple, does not require complex equipment, allows predicting the development of post-traumatic osteomyelitis at the preclinical stage, within 5 days from the moment of injury. The accuracy of the method is 91%.

Description

The invention relates to medicine, in particular to orthopedics and traumatology, and can be used to predict the development of post-traumatic osteomyelitis after fracture of long bones in the early stages of inflammation, in the absence of clinical signs.

The purpose of the invention is early prediction.

The method is carried out as follows.

From the ulnar vein of the subject, 5-6 ml of blood is taken before meals and medication. The obtained blood is incubated for 10-15 minutes at 37 ° C, centrifuged, and the content of free hydroxyproline and iron is carried out in the blood supernatant (serum). The study is conducted over a period of

the first 5 days from the date of injury. It is necessary to determine the indices of the content of free hydroxyproline and iron on the second, fourth and fifth day. When the content of free hydroxyproline and iron in these periods exceeds 1.5 ± 0.1 μg / ml and 6.3 ± ± 1.8 mmol, respectively, the development of post-traumatic osteomyelitis is predicted.

Example. Patient Sh., Diagnosis: open fracture of the right thigh. The general condition of the patient upon admission is satisfactory, the body temperature is 37.6 °, the heart rate is 90 beats per minute, BP-120/75 mm Hg. Upon admission, the primary surgical treatment of the wound was made: washing, clearing of foreign bodies, removal of non-viable tissues, washing the wound with antiseptics, comparison and

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with

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connection of bone fragments and cranes of the wound. Produced blood sampling dl. biochemical research and a complete blood count.

A biochemical study of the patient's blood serum revealed the presence of a high content of free hydroxyproline; on the first day, 4.3 µg / ml, on the second day, 5.1 µg / ml, on the third day

5.8 μg / ml, on the fourth day

7.3 µg / ml, on the fifth day of 6.8 µg / ml at a rate of 1.5 ± 0.1 µg / ml (the norm of free hydroxyproline according to Osadchuk), against the background of a high iron content at a rate of 4.5-8, 1 mmol / l: on the first day 10.9 mmol / l, on the second day 12. mmol / l; on the third day: 14.5 mmol / l; on the fourth day: 18.2 mmol / l; on the fifth day, 17.9 mmol / l. General blood test data are within normal limits. At the same time, it should be noted that the glucose indicators were within the normal range during the studied periods and were: glucose - on the first day

3.9 mol / l, on the second day

4.8mmol / l, on the third day

5.1 mmol / l, on the fourth day

5.9 mol / l, on the fifth day of 4.9 mmol / l at a rate of 3.88 6, 105 mmol / l. Total protein - the first day 85 g / l, on the second day 90 g / l on the third day 88 g / l, on the fourth day 77 g / l, on the fifth day 63 g / l, at a rate of 60-78 g / l .

Freestyle was treated according to the clinic's scheme. However, in spite of the therapy being carried out, on the first two days of the patient's stay in the hospital, the swelling of the right leg increased, in the area of the fracture during palpation, infiltration of the soft

tissues. At the same time, on the radiograph of the patient, signs characteristic of post-traumatic osteomyelitis were found, which were further confirmed clinically.

The proposed method examined more than 20 patients who developed posttraumatic osteomyelitis of the long bones at different periods of observation (up to 20 days). Within 1-5 days after injury in the absence of clinical and radiological signs of inflammation, they determined the level of free hydroxyproline in the range of 6.2Ј0.6 µg / ml at a rate of 1.5 ± 0.1 µg / ml and the average iron content of 17, 3Ј0.9 mmol / l at a rate of 6, 8 mmol / l.

The proposed method for predicting the development of post-traumatic osteomyelitis of the long bones allows early detection of the developing complication in the absence of clinical signs of inflammation as early as the first five days after the injury, and the known method only predicts maxillofacial osteomyelitis. The accuracy of the forecast is 91%.

Claims (1)

Invention Formula A method for predicting the development of post-traumatic osteomyelitis, including serum testing, characterized in that, for the purpose of early prediction, iron content and are determined. free hydroxyproline and at values higher than 6.3 i1.8 mmol and 1 μg / ml, respectively, during the first 5 days after the injury, the development of post-trauma osteomyelitis is predicted. Editor N. Yatsola Compiled by A. Anosov Tehred M. Morgental Proofreader N. Revska Order 1604 Circulation 416 VNIIPI State Committee for Inventions and Discoveries at the State Committee on Science and Technology of the USSR 113035, Moscow, Zh-35, Raushsk nab. 4/5 Subscription