The aim of our research was to analyze the results of bacteriologic examination in patients with local and disseminated chronic osteomyelitis. We performed retrospective analysis of the results of bacteriologic examination of wound exudate in 80patients who were admitted to the clinic of Irkutsk Scientific Center of Surgery and Traumatology for operative treatment of shinbone shaft fractures complicated with local and disseminated chronic osteomyelitis. We used common methods of mono- and bilocal osteosynthesis which resulted in different terms of fracture union and bone defect replacement. Bacteriologic examination of exudate from bone and soft-tissue wounds was performed in all patients at their admission to the clinic. In patients with local chronic osteomyelitis and with usual terms of fracture union, the most common were pure cultures (93.%) with dominant S.aureus (60%). In patients with delayed fracture union, the most common were microorganism associations (55.5±11.7%). In patients with disseminated chronic osteomyelitis with usual terms of defect replacement, pure cultures were registered in 90% of cases. In patients with delayed defect replacement pure cultures were found in 57,2% of cases. Comparative analysis showed that in patients with delayed fracture union and defect replacement, bacterial associa-tions were more common than in patients with usual terms of defect replacement. Preoperative bacteriologic examination showed that S.aureus was the dominant flora of wound exudate in patients with local and disseminated chronic osteomyelitis. Bacterial associations in wound exudate of patients with delayed fracture union and defect replacement is associated with significant circulation failure in affected extremity and is an unfavorable factor for reparative process disorder at chronic osteomyelitis.
The aim of the research was to assess using biodegradable screws in treatment of hallux valgus. We managed 40female patients (average age 50±2.51) with hallux valgus who where admitted to the orthopedic unit of Irkutsk Scientific Center of Surgery and Traumatology for operative treatment.All patients had X-ray, MRI and intraoperational examination of affected foot before the surgery and in postoperative period. All patients were operated using own surgical technique.Patients were divided into two groups: group1 (22patients) – osteosynthesis using biodegradable (PLGA) screws; group2 (18patients) – osteosynthesis using metal cannulated screws.In group1 postoperative values of M1P1 angle were within normal range (9.67±0.78°). According to MRI, proximal articular set angle (PASA) was corrected from 21.5±0.35 to 4.17±0.09°. 6patients of the group1 were complaining of pain and discomfort in the area of screw-head contacting soft tissues. The result of operative treatment in the group2 resulted in the correction of M1P1 angle from 34±1.63 to 7.67±0.75°. After the surgery intraoperative PASA was back to the normal range (4.33±0.34°).The comparison of the results of treatment of patients of groups1 and 2 didn’t reveal any statistically significant dif-ferences in the values of М1Р1, М1М2, М1М5 angles and PASA.The advantage of using biodegradable screws, compared to the metal ones, in the treatment of hallux valgus is the possibility of postoperative MRI of the foot with calculation of PASA to evaluate treatment results. The disadvantage of using biodegradable screws is engineering deficiency preventing screw-head from dipping into bone tissue and causing soft tissue traumatizing. Biodegradable and metal screws allow to obtain similar results of hallux valgus treatment.
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