The use of autofibrinum for the stimulation of osteoreparation in the treatment of long bones fractures

Abstract

The use of autofibrinum enriched with erythrocytes for the stimu­lation of reparative osteogenesis is one of the perspective trend of bioimplantology. The goal: to investigate the forming of bone regenerate under conditions of placing of autofibrinous clot around or between the bone fragments during the surgical treatment of patients with diaphyseal long bones fractures of extremities. Methods: the main group included 24 patients — 14 with acute fractures (tibia/fibula 5, humerus 1, femur 1, ulna 3, radius 4) and 10 with ununited fractures 4–6 month after initial trauma (humerus 5, tibia/fibula 2, forearm 2). 21 patients with acute diaphyseal fractures were included in the comparison group (tibia/fibula 8, forearm 9, humerus 4). The patients underwent osteosynthesis with LCP-plates, external fixators, intramedullary pin. Autofibrinum was produced according to J. Choukroun method. It was placed subperiostaly with covering of fracture zone or in bone defect. Regeneration in the place of clot was assessed with radiografy. The results: it was defined that 89.47 % patients of the main group had formation of bone regnerate of corresponding size with fragments healing. The expert assessment of X-ray films was performed by two independent specialist. Coefficient of agreement was equal to 0.8–1 according to Cohen’s Kappa (complete matching). The formation of periostel regenerate was noticed in 23.8 % patinets of comparison group. However, its relative height (14 ± 2.4) % was sagnificantly less comparing with the same index in main group (45 ± 10) %. Conclusion: usage of autofibrinum, produced ac­cording to J. Choukroun method, as a osteoplastic material in the surgical treatment of the long bones of extremities leads to forming of bone regenerate in the place of its location.