Efficacy and safety of hydroxyapatite-coated spokes in patients with femoral neck fractures in a multiple trauma

Purpose: to evaluate the efficacy and safety of hydroxyapatite coated spokes for osteosynthesis in patients with femoral neck fractures in a multiple trauma. Material and Methods. We studied 26 patients of both sexes with severe injuries (on the ISS scale, the severity of the injury corresponded to 22-27 points). All revealed a fracture of the femoral neck, which was combined: with bruises of the brain (N=6) or kidney (N=12), fractures of the pelvis (N=18), ribs (N=8) or shin bones (N=4), rupture of the lung (N=4). All underwent treatment aimed at stabilizing the function of internal organs and systems, osteosynthesis of the femoral neck with a bundle of spokes with their fixation in the llizarov apparatus. Patients were randomized into 2 groups: main (N=11) - for osteosynthesis spokes with hydroxyapatite coating were used; control (N=15) - spokes without coating were used. To assess the effectiveness and safety of the use of spokes with hydroxyapatite coating, clinical and laboratory methods were used. Results. In the main group, positive results of treatment were observed in 10 patients (90.9%; Cl: 67.9-99.9%), in the control group-11 (73.3%; Cl: 48.9-91.8%). The patients of the main group have an average fracture consolidation time of 1.2 times less. After surgery, the activity of alkaline phosphatase is higher (P=0.04). The frequency of deviation of laboratory blood parameters from the norm in these patients is comparable with the frequency noted in the control group. Conclusion. The use of spokes with hydroxyapatite coating in the treatment of patients with femoral neck fractures in conditions of multiple trauma reduces the duration of fixation of bone fragments and increases the number of positive results of treatment by reducing the number of complications.