The effectiveness of the implementation of new technologies in the prevention of purulent complications of repeated surgеries for complications of fractures of the proximal femur of patients

Authors

  • An. V. Kalashnikov Institute of traumatology and orthopedics of NAMS of Ukraine,
  • V. D. Malik Poltava regional clinical hospital named. M. V. Sklifosovsky,
  • Al. V. Kalashnikov Institute of traumatology and orthopedics of NAMS of Ukraine,

DOI:

https://doi.org/10.14739/2310-1210.2016.3.76992

Keywords:

Biomedical Technology, Femoral Fractures, Secondary Prevention, Suppuration, Reoporation

Abstract

Despite the latest achievements of modern traumatology, remains quite high percentage of unsatisfactory results of treatment of fractures of the proximal femur (fPf). According to the literature repeated surgery increases the risk of postoperative purulent complications in several times.

The authors of the article developed the innovations introduced in practice based on the use of thrombocytopoiesis fibrin gel, which has a high antibacterial activity due to preservation of leukocytes (local antibiotic effect), together with bone shavings during the performing of the operations when performing reactioneze and TEP after performing osteosynthesis, and also at persons of senile and elderly, for prevention of postoperative purulent complications in fPf.

A comprehensive clinical study of 120 patients with fPf complications (false joints, aseptic necrosis of the femoral head, axial deformation) after osteomyelitis who underwent re-operative intervention was provided. Patients were divided into two groups, first (control) group consisted of 60 patients with consequences fPf who underwent total endoprosthesis (TEP) of the hip joint (30 patients) and locked intramedullary nailing (LIN) (30 patients) by conventional methods. The second (experimental) group consisted of 60 patients with consequences fPf who underwent TEP of the hip joint (30 patients) and LIN (30 patients) with use developed by authors of innovations. Effectiveness of prevention of septic complications in both groups of observation was evaluated. The observation period was 1 year. There was statistically significant (p≤0.01) decrease in the number of early (4 times) and late (3 times) postoperative complications in patients of the experimental group in comparison with patients of control group. The new technologies use allows to increase in 8.4% the efficiency of preventive maintenance of purulent complications of surgical treatment of patients with complications after performing osteosynthesis in the treatment of fPf.

The introduction of the proposed new technologies will allow to carry out effective prevention of purulent complications of repeated surgical interventions in the fPf treatment, which distinguishes the proposed method from the accepted methods of prevention of postoperative purulent complications fPf treatment.

References

Haiko, H. V., Korzh, M. O., Kalashnikov, A. V., Herasymenko, S. I., & Polishko, V. P. (2008). Analiz stanu travmatolohichno-ortopedychnoi dopomohy naselenniu Ukrainy v 2006–2007 rr. [Analysis of the state of traumatologic and orthopaedic care to population of Ukraine in 2006–2007]. Kyiv: Volia. [in Ukrainian]

Akhtyamov, I. F., & Tikhilov, R. M. (2009) Eˊndoprotezirovanie v Rossii [Endoprosthesis replacement in Russia]. Moscow: Medicinskaya kniga. [in Russian].

Girshin, S. G. (2004) Klinicheskie lekcii po neotlozhnoj travmatologii [Clinical lectures on emergency traumatology]. Moscow: Azbuka. [in Russian]

Hrytsai, M. P., & Sulyma, V. S. (2014) Kistkovo-plastychne likuvannia khvorykh na khronichnyi osteomiielit [Osteoplastic treatment of patients with chronic osteomyelitis]. Ivano-Frankivsk: Talia. [in Ukrainian]

Duplenko, Yu. K. (1985) Starenie. Ocherki razvitiya problemy [Aging. Essays on development issues]. Leningrad: Nauka. [in Russian]

Zubenko, A. H. (2011) Optymizatsiia perebihu reparatyvnoho osteohenezu pry perelomakh velykohomilkovoi kistky (eksperymentalno-klinichne doslidzhennia) (Avtoref. dis…kand. med. nauk) [Optimization of the course of reparative osteogenesis at fractures of the tibia (experimental clinical research)] (Extended abstract of candidate’s thesis). Kyiv: DU AMN Ukrainy «Instytut travmatolohii ta ortopedii». [in Ukrainian]

Lazarev, A. F. (2004) Novye podkhody k lecheniyu perelomov proksymalˊnoho otdela bedrennoj kosti [New approaches to the treatment of fractures of the proximal femur]. Vestnik travmatologii i ortopedii, 1, 27–31. [in Russian]

Lapach, S. N., Chubenko, A. V., & Babych, P. N. (2000) Statisticheskie metody v biologicheskikh issledovaniyakh s ispolˊzovaniem Excel [Statistical methods in biological research using Excel]. Kyiv: Morion. [in Ukrainian]

Mintser, O. P., Voronenko, Yu. V., & Vlasov, V. V. (2003) Informatsiini tekhnolohii v okhoroni zdorovia i praktychnii medytsyni [Informacin Aharon technology in the health Fund medical prakticni], (Book 5: Obroblennia klinichnykh i eksperymentalnykh danykh u medytsyni [Obramleny clinic I have eksperimentalnih difference Fund medical]. Kyiv: Vyshcha shkola. [in Ukrainian]

Parvizi, D., & Herke, T. (2016) Rekomendatsii mizhnarodnoi pohodzhuvalnoi konferentsii z peryproteznoi infektsii. Konsensus [The recommendations of the international consensus conference on pariprasna infection. The consensus]. Kharkiv: Kolehium. [in Ukrainian]

Korzh, N. A., Gerasimenko, S. I., Klimovickij, V. G., Loskutov, A. E., Romanenko, K. K., Gerasimenko, A. S., & Kolomiec, E. N. (2010) Rasprostranennostˊ perelomov kostej y rezulˊtate ikh lecheniya v Ukraine (kliniko-eˊpidemiologicheskoe issledovanie) [The prevalence of bone fractures and results of their treatment in Ukraine (clinical-epidemiological study)]. Ortopediya, travmatologiya i protezirovanie, 3, 5–14. [in Ukrainian]

Haiko, H. V., Kalashnikov, A. V., Malyk, V. D., & Kalashnikov, O. V. (2014) Sposib profilaktyky hniinykh uskladnen pry vykonanni totalnoho endoprotezuvannia kulshovoho suhloba u khvorykh pislia poperednoho vykonannia osteosyntezu z vykonanniam metalevykh konstruktsii [Method of prevention of septic complications when performing total hip replacement in patients after a preliminary run of osteosynthesis with the implementation of metal structures]. Zhurnal Natsionalnoi akademii medychnykh nauk Ukrainy (dodatok), 37, 198. [in Ukrainian]

Haiko, H. V., Kalashnikov, A. V., Malyk, V. D., & Kalashnikov, O. V. (2014) Sposib profilaktyky hniinykh uskladnen (PHU) pry vykonanni osteometalosyntezu pry perelomakh proksymalnoho viddilu stehna (PVS) u khvorykh pislia poperednoho vykonannia osteosyntezu z vykonanniam metalevykh konstruktsii (MK) [Method of prevention of septic complications (PSС) when you run osteomyelitis for fractures of the proximal femur (PF) patients after prior execution of osteosynthesis with the implementation of metal structures]. Zhurnal Natsionalnoi akademii medychnykh nauk Ukrainy (dodatok), 37, S. 202. [in Ukrainian]

Haiko, H. V., Kalashnikov, A. V., Malyk, V. D., & Kalashnikov, O. V. (2014) Sposib profilaktyky hniinykh uskladnen (PHU) pry vykonanni totalnoho endoprotezuvannia kulshovoho suhloba u khvorykh pokhyloho ta starechoho viku (KhPSV) [Method of prevention of septic complications (PSC) when performing total hip replacement in patients of elderly and senile age (HPES)]. Zhurnal Natsionalnoi akademii medychnykh nauk Ukrainy (dodatok), 37, 196-197. [in Ukrainian]

Sulyma, V. S. (2002) Suchasni kliniko-diahnostychni aspekty khronichnoho osteomiielitu (ohliad) [Modern clinical and diagnostic aspects of chronic osteomyelitis (review)]. Ukrainskyi medychnyi chasopys, 5(31), 23–28. [in Ukrainian]

Yuriichuk, L. M. (2009) Endoprotezuvannia kulshovoho suhloba u khvorykh pokhyloho ta starechoho viku z cherez- ta mizhvertliuhovymy perelomamy stehnovoi kistky. (Avtoref. dis…kand. med. nauk). [Hip replacement in patients of elderly and senile age with through - and intertrochanteric fractures of the femur] (Extended abstract of candidate’s thesis). Kyiv: DU AMN Ukrainy «Instytut travmatolohii ta ortopedii». [in Ukrainian]

Kato, T., Kawaguchi, H., Hanada, K., Aoyama, I., Hiyama, Y., Nakamura, T., et al. (1998) Single local injection of recombinant fibroblast growth factor-2 stimulates healing of segmental bone defects in rabbits. J. Ortop. Res., 16, 654–659. doi: 10.1002/jor.1100160605.

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1.
Kalashnikov AV, Malik VD, Kalashnikov AV. The effectiveness of the implementation of new technologies in the prevention of purulent complications of repeated surgеries for complications of fractures of the proximal femur of patients. Zaporozhye Medical Journal [Internet]. 2016Sep.6 [cited 2024Nov.26];18(3). Available from: http://zmj.zsmu.edu.ua/article/view/76992

Issue

No. 3 (2016): Zaporozhye medical journal

Section

Original research

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