[Comparative assessment of mineral metabolism in shoulders and crura in patients with osteomyelitis.] / Сравнительная оценка минерального обмена у пациентов с остеомиелитом плеча и голени.

Chronic osteomyelitis in long tubular bones is generally aggravated by metabolic imbalance in patients' organisms affecting mineral metabolism. It is critically important that the extent of this imbalance should be determined prior to surgical intervention to choose optimal methodology, proper monitoring of recovery and adequate prognostication of final results. With this in mind a comparative assessment has been carried out to shed light on the intensity of mineral metabolism in the blood serum of patients suffering from osteomyelitis in their shoulders and crura. Dynamics of how indices of electrolytes and activity of acidic and alkaline phosphatases vary have been studied in blood serum samples in 24 patients, 18 patients suffering from osteomyelitis in crus bones and 6 - in shoulders. In addition, correlations between total calcium, inorganic phosphate and phosphatase index have been computed. The mineral metabolism indices which were exhibited by the patients having shoulder osteomyelitis and by the patients with crus osteomyelitis are statistically meaningful differences prior to surgery and 2-3 days after surgery. 21 days after surgical intervention the activity of osseous remodeling enzymes, content of total calcium and phosphates as well as the correlations with the phosphatase index show no significant differences. These specific features of mineral metabolism turn out to level out in the process of treating chronic osteomyelitis in upper and lower limbs with transosseous compression-distraction osteosynthes. It has been the first study aimed at discovering comparative characteristics of mineral metabolism in patients with shoulder osteomyelitis and the ones with crus osteomyelitis at different times following surgical intervention. The study looks into correlations between the electrolytes and the mineralization index and shows specific traits exhibited by patients who suffering from osteomyelitis in shoulder and crus went through reparative regeneration at different periods of treatment.

[Bone quality of lower limbs in patients with chronic osteomyelitis aged over 60 years according to multi-slice computed tomography.]

Radiography and multi-slice computed tomography (MSCT) were used to examine 30 patients with chronic osteomyelitis of lower limb whose age was over 60 years. There were more male patients with posttraumatic osteomyelitis of tibia. 16 patients were treated for chronic osteomyelitis for more than 5 years and 9 patients for more than 15 years. Control groups included 30 patients with chronic osteomyelitis of long bone aged 20 to 45 years and 30 patients aged 46 to 59 years. Radiographs of 19 patients of index group (63,3%) showed osteomyelitic cavities in the femur and tibia. Radiomorphological changes were observed in the adjacent segment of all the patients. Changes in bone architechtonics were manifested in expressed polymorphism, without evident signs of osteoporosis due to the spread sclerosis in osteomyelitic nidus. Information obtained with MSCT preoperatively was comprehensive and revealed location of purulent and necrotic nidus, type of destruction, extent and location of involved bone tissue that provided a possibility of choice of the most efficient surgical intervention.