ДИНАМИКА ИЗМЕНЕНИЯ ЗНАЧЕНИЯ КРЕАТИНКИНАЗЫ ПРИ ПРОВЕДЕНИИ БЛОКИРУЕМОГО ИНТРАМЕДУЛЛЯРНОГО ОСТЕОСИНТЕЗА БОЛЬШЕБЕРЦОВОЙ КОСТИ

Abstract

The aim of this research to study the level of creatine kinase in patients with fractures of the tibia before blocking intramedullary osteosynthesis, during surgical treatment and in the postoperative period to assess the condition of muscle tissue, data compliance, and the effectiveness of prevention of the development of local hypertensive ischemic syndrome. The work is based on the study of the results of treatment of 40 patients with diaphyseal fractures of the tibia, who underwent blocked intramedullary osteosynthesis. The creatine kinase level was determined before surgery, during surgery, 24 and 48 hours after surgery. The patients of the control group underwent preventive fasciotomy during surgical treatment. The following results were obtained in patients of the main group: the total level of creatine kinase before surgery was 155±21 mIU/L in women, 182 ±14 mIU/L in men. During the blocked intrameddulary syntesis, we obtained the following data: in female patients, the creatine kinase level was 190 ± 13 mIU/L, in men - 242 ±12 mIU/L. 24 hours after surgery, in female patients, the creatine kinase level was 221±14 mIU/L, in male patients – 271±12 mIU/L. After 48 hours, the creatine kinase level in female patients was 160±6 mIU/L, in male patients - 180±7 mIU/L. In the control group, the indicators were as follows: before surgery, the QC level in female patients was 150±14 mIU/L, in male patients – 185±11 mIU/L. During surgery, the creatine kinase level was 188±11 mIU/L, in men 244±10 mIU/L. 24 hours after surgery, the following data were obtained: in female patients, the creatine kinase level was 250±11 mIU/L, in male patients – 300±14 mIU/L. After 48 hours, the creatine kinase index in patients was 235±12 mIU/L, in men, respectively, 252±14 mIU/L. According to sources, an increase in creatine kinase of more than 50% of the reference values indicates damage to muscle tissue. The data obtained indicate significantly lower creatine kinase values in patients who underwent preventive closed fasciotomy. The subfascial pressure study was carried out using a Stryker device in several stages. The results obtained allow us to conclude that the study of creatine kinase levels is effective in controlling the clinical course of local hypertensive ischemic syndrome.