Современные методы медикаментозной и локальной терапии замедленной консолидации переломов (обзор литературы)

Abstract

Introduction Management of post-traumatic disorders of bone regeneration continues to be a substantial clinical challenge in orthopaedic trauma. These include refracture, nonunion, delayed consolidation. The purpose is to explore modern methods of treatment of delayed fracture consolidation. Methods The literature search was produced via open access electronic databases of scientific literature PubMed and eLIBRARY. Search depth was 10 years. Results The article presents methods of medication and local therapy for delayed fracture consolidation. The effectiveness of the use of the ossein-hydroxyapatite complex and vitamin D is reported in patients with normalized healing time of a long bone fracture. The findings showed that bisphophonates, denosumab and strontium ranelate can reduce the risk of fractures with no adverse effect on bone healing. There is controversy on the effect of Teriparatide improving fracture healing. This review will envisage the current clinical trials on bone healing augmentation based on bone grafts, bone substitutes, synthetic growth factors, cell therapy and PRP therapy. Local use of bisphosphonates administered either alone or in combination with other agents is of great interest. Bisphosphonates (etidronate) locally applied in combination with lanthanide ions and calcium for animal fractures demonstrated a positive effect on the reparative process. Conclusion The applicability of medication and local therapy is very high in the treatment of patients with delayed fracture consolidation. Despite numerous studies many questions remain unresolved, and there is a need for the investigations. The local use of bisphosphonates was shown to be promising in the management of delayed fracture consolidation.