Age Features of Periostal Callus Formation in Patients with Closed Fractures Bones of the Shoulder and of the Tibia

Abstract

Treatment of patients with fractures of the bones of the leg in an outpatient setting occurs under conditions of a forced increase in the axial load on the injured lower limb. The aim of the study was to determine the conditions for the formation of periosteal callus of the shoulder and lower leg and to assess the effect on its formation of the time frame for fixation of bone fragments in people of different ages under the conditions of treatment in the outpatient setting. Two groups of patients with closed diaphyseal bone fractures were examined using the Ilizarov method. The first group consisted of 29 patients with fractured shoulders aged from 24 to 94 years (43 ± 3). The second is 36 patients aged from 17 to 84 years (44 ± 4) with fractures of the bones of the leg in the conditions of Ilizarov treatment. All patients were treated for the first 2 weeks in inpatient, and later on in the outpatient setting. It was found that increased motor mode and axial load on the limb in the conditions of outpatient treatment lead to an increase in the period of fixation of bone fragments as compared with the previously recommended G.A. Ilizarov standards by 60% and the appearance of periosteal callus. At the same time, the size of callus on the tibia is relatively more than on the shoulder by 43% (p ≥ 0.05), while the timing of fixation of bone fragments was not statistically significantly different. Increasing the size of callus is favorable for reducing the time of fixation of fragments in patients with shoulder injury. In patients with a leg injury of working age with an increase in the number of past years, the size of the periosteal callus also became larger, however, this increase only influenced the reduction of fixation time when the shadow size of the callus reached 360 mm2. At the same time, on the lower legs, the time of fixation of fragments, unlike patients with shoulder herbs, after the formation of callus, ceases to depend on the initial micromobility of bone fragments that took place after the application of the Ilizarov apparatus. As a result, no selective adverse effect of an increase in the load on the lower leg was revealed on the terms of treatment of patients with lower leg injuries on an outpatient basis.