Оценка эффективности влияния совместного использования оссеин-гидроксиапатитного комплекса и бисфосфонатов на сроки консолидации переломов и минеральную плотность костной ткани

Abstract

Despite advances in traumatology and orthopedics, the problem of fracture treatment remains topical. To normalize the timing of fracture healing, both drug treatment and local factors of reparative osteogenesis stimulation are used. The purpose — to study the effect of the combined use of an ossein-hydroxyapatite complex and bisphosphonates on the timing of fracture consolidation and on the bone mineral density. Material and methods. In 20 patients aged 50 to 75 years with closed fractures of the femoral diaphysis after intramedullary metal osteosynthesis, the timing of fracture healing and the changes in bone mineral density were assessed one year after the fracture in two equal in number and comparable groups. In the comparison group, patients received ossein-hydroxyapatite complex and сolecalciferol; in the main group, patients received ossein-hydroxyapatite complex, сolecalciferol, and 1 month after the operation, they received a single intravenous injection of zoledronic acid. The RUST scale was used to assess the signs of fracture union by radiographs. Complete union of the fracture was recorded with a total of 10 or more points. Osteodensitometry was performed in patients twice, after surgery and one year after it. Results. With the combined use of the ossein-hydroxyapatite complex and bisphosphonates in patients in the study group, the timing of fracture healing was 2.1 weeks less than in the comparison group, and the increase in bone mineral density in the lumbar spine was by 1.8% larger, in the femoral neck by 1.4% larger in the main group than in the comparison group. Although according to clinical studies, the systemic use of bisphosphonates did not affect the timing of fracture healing, with the combined use of ossein-hydroxyapatite complex and zoledronic acid, there was a greater increase in bone mineral density and a decrease in the timing of union of a femoral fracture after intramedullary metal osteosynthesis than when using only ossein-hydroxyapatite complex. Conclusions. A positive effect of the combined use of the ossein-hydroxyapatite complex and bisphosphonates in patients on the timing of fracture healing and bone mineral density was revealed, which is the basis for further research on the use of these drugs in a larger number of patients.