SEARCH FOR LABORATORY TESTS FOR PREDICTING DELAYED UNION FRACTURES OF BONES IN PATIENTS WITH POLYTRAUMA (A PILOT STUDY)
Objective - search for possible laboratory criteria for predicting delayed fracture healing in limb bones in patients after polytrauma. Materials and methods. The study included 19 patients with polytrauma. The first group included 6 patients (3 men and 3 women) with slowing fracture healing 3 months after the injury. The average age of patients in this group was 41.6 ± 11.3 years. The remaining 13 patients (8 males and 5 females) were the second group, the average age - 35.1 ± 7.1 years. Differences in the location and severity of bone fractures of a limb (by AO/ASIF classification) were not found in the groups. In all patients, a comparative assessment of the dynamics of changes of biochemical parameters of blood serum was conducted. Results. The study did not find any statistically significant differences in the clinical values in the patients of the examined groups. The patients of the group 1 did not show any clinical radiological features. Alkaline phosphatase activity was the single biochemical value with evident time course and significant intergroup differences. The average values of the activity of this enzyme in the patients in the group 2 on the days 21, 30 and 60 days after the injury were significantly higher than those of the patients in the group 1. A positive diagnostic sign, which indicates a risk of slowing bone formation, is the normal activity of alkaline phosphatase at hospital discharge, the odds ratio (OR) of a positive test result - 6.7 (95% confidence interval: 0.8 ÷ 56.2). Conclusion. Determination of alkaline phosphatase activity is a possible criterion for predicting slow fracture healing in patients with multiple injuries.