Relationships between morphological indicators of the tibia and soft tissues lesions and some biochemical blood indicators in patients with traumatic osteomyelitis

Abstract

Aim. Research aim was to find statistical differences of biochemical indicators of blood and morphometric indicators of crural tissue lesion and relationships between them in patients with traumatic osteomyelitis of the tibia with trophic disturbances in extremity. Material and methods. The work material includes data from 28 patients with traumatic osteomyelitis which was combined with trophic tissue disturbances of different manifestation degree. The levels of procalcitonin, lactate dehydrogenase and acetylcholinesterase of blood serum were estimated. In crural tissues quantitative biochemical, gradual morphometric indicators, frequencies of occurrence of different manifestation degree cases and relationships “clinic – biochemistry – pathomorphology” were defined histologically. Results. Average values of procalcitonin, lactate dehydrogenase and acetylcholinesterase in patients with traumatic osteomyelitis of the tibia, combined with trophic disturbances in crural tissues, are significantly higher, than average values of these indicators in intact donors. In the majority of the patients with chronic traumatic osteomyelitis in crural tissues pathological changes were found out, which by clinical estimations are considered as trophic disturbances. They represent a combination of discirculatory, ischemic-necro­tic, exsudative, productive-inflammatory, and also reparative processes which in total create a composite picture of complex lesion and can persist for many years. As closest relations, according to values of association coefficient, concerning certain biochemical indicators, can be noted such clinical indicators: “degree of bone fragments non-consolidation” and “severity of trophic disturbances in bone tissue (by clinical estimation)”, concerning defined morphometric indicators – such biochemical indicators: “level of procalcitonin” and “level of lactate dehydrogenase” in blood serum. Among morphometric lesion indicators the closest relations concerning biochemical indicators were revealed: in bones – “the form of the pathological focus of traumatic osteomyelitis” and “presence of sequesters”, in soft tissues – “exsudative inflammation in internal membrane of a focus capsule”. Conclusions. In chronic traumatic osteomyelitis combined with trophic disturbances of crural tissues, there are relationships between some clinical, biochemical and morphological indicators of the extremity tissues condition. A deviation of metabolism indicators from norm can serve as biochemical markers in definition of severity degree and efficiency of treatment in patients.