The correction of impaired bone tissue metabolism – is a component of complex therapy for chronic post-traumatic osteomyelitis of long bones 

Archil V. Tsiskarashvili, Candidate of medical sciences, head of the department of consequences of injuries of the musculoskeletal system and bone and joint infection No. 5, National Medical Research Center for Traumatology and Orthopedics named after N.N. Priorov (10 Priorova street, Moscow, Russia), E-mail: armed05@mail.ru
Aleksandr Yu. Taraskin, Postgraduate student, National Medical Research Center for Traumatology and Orthopedics named after N.N. Priorov (10 Priorova street, Moscow, Russia), E-mail: aletr2009@yandex.ru
Dmitriy S. Gorbatyuk, Traumatologist-orthopedist, National Medical Research Center for Traumatology and Orthopedics named after N.N. Priorov (10 Priorova street, Moscow, Russia), E-mail: naddis@mail.ru
Svetlana S. Rodionova, Doctor of medical sciences, professor, head of the scientific and clinical center for osteoporosis, National Medical Research Center for Traumatology and Orthopedics named after N.N. Priorov (10 Priorova street, Moscow, Russia), E-mail: rod06@inbox.ru 

Background. The genesis of bone and joint infection can not be described simply as a local destruction of bone tissue. The influence of the pathogen on bone remodeling reduces the effectiveness of conventional therapeutic measures. In this research, the possibility of supplementing the standard treatment regimen is analyzed, which includes surgery and antibacterial drugs, with therapy aimed at correction of metabolic disorders in the bone tissue that occur with the infectious process as a background. The purpose of the study is to demonstrate the effectiveness of the use of alfacalcidol, ossein-hydroxyapatite complex and bisphosphonate in combination with the generally accepted protocol for the treatment of pseudarthrosis of long bones with the background of chronic osteomyelitis. Materials and methods. A clinical example is presented, with the consistent use of standard therapy, and subsequent, associated with an unsatisfactory result, the appointment of an examination for the presence of balance disorders of bone remodeling, as well as further therapeutic correction of the identified disorders in combination with surgical treatment and antibacterial therapy. Results. This observation confirms the presence of metabolic disorders in the bone tissue in a patient with chronic osteomyelitis (consistent with previous scientific works). Normalization of bone remodeling indicators against the background of the therapy performed, as we believe, became the basis for a positive outcome of treatment. Conclusion. The data obtained indicate that the therapy aimed at correcting metabolic disorders, as an addition to generally accepted methods of treatment, contributes to achieving a favorable result. 

metabolic disorders of bone tissue, chronic post-traumatic osteomyelitis, external fixation 

Tsiskarashvili A.V., Taraskin A.Yu., Gorbatyuk D.S., Rodionova S.S. The correction of impaired bone tissue metabolism - is a component of complex therapy for chronic post-traumatic osteomyelitis of long bones. Izvestiya vysshikh uchebnykh zavedeniy. Povolzhskiy region. Meditsinskie nauki = University proceedings. Volga region. Medical sciences. 2022;(1):12–25. (In Russ.). doi:10.21685/2072-3032-2022-1-2