Fishchenko V. O., Lytvyniuk O. M.

FEATURES OF AUTOLOGOUS CANCELLOUS BONE GRAFTING IN GUNSHOT FRACTURES WITH BONE DEFECTS

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About the author:

Fishchenko V. O., Lytvyniuk O. M.

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CLINICAL AND EXPERIMENTAL MEDICINE

Type of article:

Scientific article

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The problem of treating patients with gunshot fractures is particularly relevant under current conditions. The aim of this study was to characterise the clinical outcomes of using autologous bone grafts in the treatment of patients with gunshot fractures, taking into account the nature of bone tissue defects. Clinical outcomes of autologous can cellous osteoplasty for bone defects were analysed in 58 patients with gunshot fractures of long bones. The mean age of the patients was 39.09 ± 9.04 years. Treatment outcomes were evaluated using the Neer–Grantham–Shelton scale. Injury characteristics were assessed using the classification of long bone defects in combat-related extremity trauma and Tetsworth’s classification of bone defects. Absolute values of defect size were also evaluated. Statistical analysis was performed using IBM SPSS Statistics 27.0.1. Results were considered statistically significant at p ≤ 0.05. The mean clinical outcome score following autologous cancellous osteoplasty was 70.05 ± 15.33 points. Excellent outcomes were observed in 9 (15.52%) patients, good in 24 (41.38%), satisfactory in 17 (29.31%), and unsatisfactory in 8 (13.79%) patients. The mean size of the bone defect was 5.14 ± 2.16 cm. Factors associated with significant ly better clinical outcomes of autologous cancellous osteoplasty in gunshot fractures with bone defects included: bone defects up to 5 cm in size (τ = +0.61, p = 0.00000000001); defects of type D3 A (τ = +0.53, p = 0.000000004); B3 (τ = +0.43, p = 0.000002); and C1 (τ = +0.24, p = 0.007). Factors associated with significantly worse clinical out comes of autologous cancellous osteoplasty included: bone defects larger than 5 cm (τ = -0.61, p = 0.00000000001); defects of type C2 (τ = -0.18, p = 0.047); C3 (τ = -0.47, p = 0.0000001); D3 B (τ = -0.20, p = 0.03); and D3 C (τ = -0.48, p = 0.0000001). Thus, the high effectiveness of autologous bone grafting in the treatment of patients with gunshot fractures and bone tissue defects has been confirmed.

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Bibliography:

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Publication of the article:

«Bulletin of problems biology and medicine», Issue 2,177, 277-288 pages, index UDC 616.718.1-001.5-089.844

DOI:

10.29254/2077-4214-2025-2-177-277-288