Optimization of reparative regeneration with autologous platelet-rich plasma in the calcaneal fractures

Authors

  • O.V. Tribushny State Institution “Zaporizhzhia Medical Academy of Postgraduate Education of the Ministry of Health of Ukraine”, Zaporizhzhia, Ukraine,
  • I.I. Trufanov State Institution “Zaporizhzhia Medical Academy of Postgraduate Education of the Ministry of Health of Ukraine”, Zaporizhzhia, Ukraine, http://orcid.org/0000-0003-1628-1268
  • V.V. Kosilo State Institution “Zaporizhzhia Medical Academy of Postgraduate Education of the Ministry of Health of Ukraine”, Zaporizhzhia, Ukraine,
  • Yu.P. Klyatskiy State Institution “Zaporizhzhia Medical Academy of Postgraduate Education of the Ministry of Health of Ukraine”, Zaporizhzhia, Ukraine,

DOI:

https://doi.org/10.22141/1608-1706.4.21.2020.212536

Keywords:

platelet-rich plasma, reparative regeneration, bone remodeling, calcaneal fractures

Abstract

Background. The number of unsatisfactory treatment outcomes in intra-articular calcaneal fractures reaches 34 %. The search for the optimal minimally invasive method of treatment, which can be used even in compromised conditions, reduces trauma, promotes the start of early rehabilitation and optimizes the processes of reparative regeneration, is very important. One of the ways to optimize the process of reparative regeneration is the use of platelet-rich plasma. The aim of the study: to analyze the results of treatment of patients with intra-articular calcaneal fractures and to optimize the reparative regeneration of bone tissue using platelet-rich plasma. Materials and methods. In 2017–2019 (the first half of the year), 79 patients with calcaneal fractures were treated at the trauma unit of Zaporizhzhia City Clinical Multidisciplinary Hospital 9. Bilateral fractures occurred in 11 cases (13.9 %). Gender composition: men — 71 (89.9 %), women — 8 (10.1 %). Mechanism of injury: falling from height (more than 1.5 m) — 47 (59.5 %), domestic — 32 (40.5 %). The following surgical interventions were performed: osteosynthesis with wires — 62 (74.7 %), with screws — 7 (8.4 %), using plates and external fixation devi­ces — were not performed. Fourteen (16.9 %) individuals refused surgical treatment. Results. In the main group of patients treated with platelet-rich plasma, X-ray fracture union occurred 6 weeks after in 6 people (85.7 %), in 1 patient (14.3 %) it occurred in 12 weeks (a case of severe comminuted intra-articular fracture). In the control group, union at week 8 was noted in 14 patients (58.3 %), in 8 (33.3 %) — at week 16, in 2 patients (8.4 %) the postoperative period was complicated by the cavity of bone resorption. Conclusions. The use of platelet-rich plasma for regeneration of bone tissue, along with traditional surgical methods, has a rather significant clinical potential. The proposed minimally invasive procedure for operative treatment in combination with the introduction of platelet-rich plasma can be used even in complicated cases.

References

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Published

2020-08-01

Issue

Section

Original Researches