Лабораторные тесты в оценке риска развития гетеротопической оссификации

Abstract

Heterotopic ossification (HO) is a common complication after injuries and orthopedic interventions. The aim of the study is to assess the feasibility of using laboratory tests to predict and determine the degree of risk of developing heterotopic ossification in patients after surgical treatment of bone fractures. Materials and methods. The results of surgical treatment of the effects of a humeral fracture in 25 patients were analyzed. In retrospect, all patients were divided into two groups: the main group included patients (n=9), who after surgery of the elbow fractures developed complications in the form of HO elbow para-articular tissues. The control group (n=16) consisted of patients who in the year after elbow fractures surgery developed no complications in the form of HO. Blood tests were performed in all patients prior to treatment, 7 days after surgery and at discharge from the hospital. The two groups of comparison (main and control) were comparable in age, time elapsed from the injury, the type of surgery performed, and length of hospital stay. Results. As a result of the study three potential predictors of HO were distinguished by laboratory tests in patients of the main group at the time of discharge: 1) high values of lactate (cut point with 100% sensitivity of the test – 2.32 mmol/l); 2) high values of hemoglobin (cut point with 100% sensitivity of the test – 130 g/l); 3) decreased activity of bone isoenzyme of acid phosphatase (cut point with 100% sensitivity of the test – 4.4 U/l). The odds ratio for a positive result of all three tests for predicting heterotopic ossification is 15.0. Conclusion. The identified laboratory tests allow to predict and determine the degree of risk of heterotopic ossification in patients after treatment of the effects of bone fractures.