Sequential analysis of oxidative stress markers and vitamin C status in acute bacterial osteomyelitis.

In bacterial bone infections, excessively formed oxidants may result in local and systemic oxidative stress. Vitamin C is the major extracellular nonenzymatic antioxidant, also implicated in bone cells metabolism and viability. The physiological functions of vitamin C largely depend on its redox status. We sequentially assessed oxidative stress markers, hydroperoxides and malondialdehyde (MDA), total antioxidant activity (AOA), total vitamin C, ascorbic acid (Asc), and oxidized/reduced vitamin C ratio in 137 patients with acute osteomyelitis (OM). Compared to 52 healthy controls, in OM group baseline serum hydroperoxides, MDA and oxidized/reduced vitamin C ratio were higher whilst Asc and AOA were lower (P < 0.05, resp.). On the other side, total vitamin C levels in patients and controls were similar (P > 0.05), thereby suggesting a relative rather than absolute vitamin C deficiency in OM. During the follow-up, oxidative stress markers, AOA, and oxidizedreduced vitamin C ratio were gradually returned to normal, while there was no apparent change of total vitamin C concentrations. Persistently high values of oxidized/reduced vitamin C ratio and serum MDA were found in subacute OM. In conclusion, acute OM was associated with enhanced systemic oxidative stress and the shift of vitamin C redox status towards oxidized forms.

[Stability and quality of osteosynthesis in treatment of tibial pylon fractures with dynamic external fixation typ Mitkovic].

UNLABELLED: The study included 35 patients with fractures of distal tibia treated at the department of orthopedics HC K. Mitrovica and the Orthopedic clinic in CHC of Nis by a dynamic external fixator fixation of ancle. Ovadia-Beals score was used to assess the quality and repositioning and to assess the stability assessment made osteosynthesis. The final functional result of treatment the patient was determined based on the AOFAS score. Deviations for postoperative talocrural angle for extraarticular fractures was approximately 6 degrees (excellent result). Student's T-test showed statistically significant difference (t = 1.693 p < 0.05) before and after surgery in favor of a postoperative series in the analysis of articular fractures by Ovadia-Beals score, and that means much better anatomical conditions for healing. Student's T-test were not found statistically significant differences in postoperative radiographic parameters in postoperative series and series before removing fixator for the extraarticular and intra-articular fractures, for extraarticular fractures (t = 1.440, p > 0.05), and intrarticular fractures, (t = 1.234, p > 0.05), which is a remarkable result and describes the remarkable stability of the fracture zone by this method. Distribution of complications: soft-tissue complications of 11.4%, healing in a bad position of 5.7%, nonunions 3%, infection 6%. Distribution of functional results according to AOFAS score: excellent 27.2%, good 40%, satisfactory 11.4% 11.4% bad. Pearson's test (r = - 0.6002) has been shown that the weight of the fracture is correlated with the AOFAS score, or the level of the outcome of treatment decreases with the increase cominution of fracture zone. CONCLUSIONS: The lack of clear protocols in the literature; the method of dynamic external fixator fixation provides optimal biochemical conditions for the healing of these injuries; the final functional outcome of this series and the distribution and number of complications corresponding to the current data in the literature.