Optimization of reparative regeneration with autologous platelet-rich plasma in the calcaneal fractures
Keywords:platelet-rich plasma, reparative regeneration, bone remodeling, calcaneal fractures
AbstractBackground. 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.
Hasʹko M.V., Kovalʹchuk P.YE., Zinchenko A. T. ta in. (2017) Nash dosvid khirurhichnoho likuvannya khvorikh z perelomamy p'yatkovoyi kistky [Our experience in surgical treatment of patients with calcaneus fractures]. /Bukovynsʹkyy medychnyy visnyk/; (in Ukraine); Tom 21, № 2 (82), ch. 2: 173-175.
Kozopas V.S. (2017). Dosvit likuvannya vnutrishnosuglobovikh perelomiv p'yatkovoyi kistky metodom nakistkovogo osteosynthesy [More information on internal fractures of the primary bone by the method of extramedullary osteosynthesis]/Clinical hirurgia, (in Ukraine); (4): 66–68.
Lantukh T.A. (2014). Pokazaniya i protivopokazaniya k khirurgicheskomy lecheniu vnutrisustavnikh perelomov pyatochnoi kosti [Indications and contraindications for surgical treatment of intraarticular calcaneus fractures [abstract of diss.]]. Moscow: GBOUDPO “RMAPO” MLR, 17s.; (in Russia)
Korobushkin G.V. (2015). Optimizazhiya lecheniay bolnikh s povrezhdeniaymi kostei stopi [Optimization of the treatment of patients with damage to the foot bones [diss.]]. Moscow: GBOUDPO RNIMU im.N.I. Pirogova (in Russia); MZR, 369 s.
Lyabakh A.P., Omelchenko T.M., Khomich S.V., et al. (2012). Likuvanny fracture of the pіyatkovo brush and that naslіdkіv (oglyad literaturi) [Treatment of calcaneus fractures and their effects (literature review)]./Newsletter of orthopedics, traumatology and prosthetics, (in Ukraine); No. 3: 70–75.
Tsybul E.S., Rodomanova L.A. (2015). Ispolzovanie tekhnologii rekonstryktivnoi mikrokhiryrgii pri lechenii bolnikh s deformaziyami I defektami pyatochnoi kosti (obzor literaturi) [The use of reconstructive microsurgery technologies in the treatment of patients with calcaneus deformities and defects (literature review)]. / Traumatology and Orthopedics of Russia, (in Russia); (4): 144–153.
Kalensʹkyy V.O., Ivanov P.A., Sharyfullyn F.A., et al. (2018). Porivnyannya trʹokh sposobiv likuvannya perelomiv p'yatkovoyi kistky [Comparison of three treatments for calcaneus fractures] / Travmatolohiya ta ortopediya Rosiyi, (in Russia); 24 (3): 103-112.
Tolstov D.A., Bohdan V.H. (2012). Trombotsytarnyy kontsentraty: klasyfikatsiya, tekhnolohiyi otrymannya, biolohichni efekty [Platelet concentrates: classification, production technologies, biological effects] / Viysʹkova medytsyna. (in Russia); (3): 141-144.
Tedesco M., Pranteda G., Chichierchia G., et al. (2018). The use of prp (platelet-rich plasma) in patients affected by genital lichen sclerosus: clinical analysis and results. J. Eur. Acad. Dermatol. Venereol.; Jul. 27.
Grageda E., Lozada J.L., Boyne P.J., et al. (2005). Bone formation in the maxillary sinus by using platelet-rich plasma: An experimental study in sheep. J. Oral Implantol; 31:2.
Radomsky O.A., Ryabokon P.V. (2017). Rozrobka sposoby osteosyntesy vnutrishnyosuglobovikh perelomiv pyatkovoi kistki blokovanim strizhnem (osteometrichne doslidzhennya) [Development of a method of osteosynthesis of intra-articular calcaneus fractures with a blocked rod (osteometric study)] / Trauma, (in Ukraine); 15 (3): 76-79.
Nanynets V.Ya., Lyabakh A.P. (2016). Diferenzhiina diagnostika bolyovogy sindromy v zadnoymy viddili stopy y pazientiv iz nepravelno zroshenimy perelomami pyatkovi kistky [Differential diagnosis of pain in the posterior foot in patients with irregular heel fractures ] / Orthopedics, traumatol. and prosthesis. (in Ukraine); 2 (89): 58-59.
Stehlik Jiri, Stulik Jan, et al. (2005). Calcaneus fractures. ISBN: 8072623281. Prague: Galén; (in the Czech Republic). 114s.
Kozopas V.S., Lobanov V.G, Siklitsky V.V., et al. (2017). Klinichni aspekti diagnostiki ta likuvannya vnutrishnosuglobovikh perelomiv pyatkovi kistky [Clinical aspects of diagnosis and treatment of intra-articular calcaneus fractures] / Trauma, (in Ukraine); 18 (6): 174–179.
Lantuh T.A., Volna А.А., Zagorodniy N.V., et al. (2013) ABCDEF-shkala otsenki riska razvitiya hirurgicheskih oslozhneniy pri operativmom lechenii vnutrisustavnih perelomah pyatochnoi kosti sо smecheniem [ABCDEF-scale for assessing the risk of developing surgical complications in the surgical treatment of displaced intra-articular calcaneal fractures]. // Bulletin of the KRSU (in Kyrgyz Republic). T. 13.No. 4.P. 122-124.
Popelka V, Zamborsky R. Operative treatment algorithm for intra-articular calcaneal fractures. Acta Orthop Belg. 2018;84(4):469-478
Peng Y, Liu J, Zhang G, et al. Reduction and functional outcome of open reduction plate fixation versus minimally invasive reduction with percutaneous screw fixation for displaced calcaneus fracture: a retrospective study. J Orthop Surg Res. 2019;14(1):124. Published 2019 May 9. doi:10.1186/s13018-019-1162-5
Copyright (c) 2020 TRAUMA
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our edition uses the copyright terms of Creative Commons for open access journals.
Authors, who are published in this journal, agree with the following terms:
- The authors retain rights for authorship of their article and grant to the edition the right of first publication of the article on a Creative Commons Attribution 4.0 International License, which allows others to freely distribute the published article, with the obligatory reference to the authors of original works and original publication in this journal.
- Directing the article for the publication to the editorial board (publisher), the author agrees with transmitting of rights for the protection and using the article, including parts of the article, which are protected by the copyrights, such as the author’s photo, pictures, charts, tables, etc., including the reproduction in the media and the Internet; for distributing; for the translation of the manuscript in all languages; for export and import of the publications copies of the writers’ article to spread, bringing to the general information.
- The rights mentioned above authors transfer to the edition (publisher) for the unlimited period of validity and on the territory of all countries of the world.
- The authors guarantee that they have exclusive rights for using of the article, which they have sent to the edition (publisher). The edition (the publisher) is not responsible for the violation of given guarantees by the authors to the third parties.
- The authors have the right to conclude separate supplement agreements that relate to non-exclusive distribution of their article in the form in which it had been published in the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.
- The policy of the journal permits and encourages the publication of the article in the Internet (in institutional repository or on a personal website) by the authors, because it contributes to productive scientific discussion and a positive effect on efficiency and dynamics of the citation of the article.
- The rights to the article are deemed transferred by the authors to the edition (the publisher) since the moment of the publication of the article in the printed or electronic version of journal.