The First Experience of Dynamic Intramedullary Osteosynthesis of Diaphyseal Fractures of the Tibia Using Implants Based on Magnesium Alloy

Summary. The efficiency of using the dynamic blocking intramedullary osteosynthesis (BIOS) technique for tibial fractures with the use of biodegradable implants based on the MS-10 magnesium alloy was determined. Objective: to approve the technique and to study the effectiveness of dynamic intramedullary osteosynthesis of diaphyseal fractures of the tibia using locking screws made of the biodegradable magnesium alloy MS-10. Materials and Methods. The study was carried out in the Department of Traumatology of the Municipal Non-Profit Enterprise “City Hospital of Emergency and Ambulance” of Zaporizhzhia City Council in Zaporizhzhia on 15 patients with diaphyseal fractures of the tibia, who underwent BIOS. Cannulated intramedullary titanium rods were used as a fixator. In the proximal section, a screw made of titanium alloy was introduced into a dynamic hole; a screw made of a biodegradable magnesium alloy MC-10 was inserted into a static hole. In the postoperative period, the patients underwent a course of complex rehabilitation measures. X-ray control was performed on day 1, at week 4, week 8, and week 16 after the surgery. Results. After the start of the dosed load on the injured limb, a fracture of the locking screw made of MC-10 alloy was radiographically recorded in all patients. The dynamic screw moves in the dynamic hole and the fracture is dynamized. The formation of callus in the fracture zone was unremarkable and took an average physiological time. The quality and structure of callus did not show any pathological features. Four months after the surgery, all patients were socially adapted and did not use additional support when moving. Conclusions. Based on the data obtained, it is possible to draw a conclusion about the possibility and advisability of using biodegradable implants made of magnesium alloy MS-10 in a dynamic BIOS of long bones of the human skeleton.

Download Full-text

PROGRESSION OF INFLAMMATORY PROCESSES IN PATIENTS AFTER IM NAILING USING BIOINERT AND BIODEGRADABLE IMPLANTS BASED ON MC-10 MAGNESIUM ALLOY

The problems of traumatology and osteosynthesis ◽

10.51309/2411-6858-2021-20-1-3-17 ◽

2021 ◽

pp. 3-17

Author(s):

E. V. Yatsun ◽

G. O. Prozorova ◽

V. M. Chorny ◽

M. L. Golovakha ◽

D. V. Ivchenko

Keyword(s):

Magnesium Alloy ◽

Negative Impact ◽

Modern Medicine ◽

Biodegradable Implants ◽

Round Hole ◽

Before And After ◽

Inflammatory Processes ◽

Diaphyseal Fractures ◽

Im Nailing ◽

Biodegradable Magnesium

Summary. Modern medicine widely uses artificial materials to replace damaged tissues and organs. Biodegradable implants should be gradually replaced with living tissue and stay functioning within a specified period, don’t have any negative impact on surrounding tissues and a human body in general. Clinical studies of biochemical values specifying the intensity of inflammatory response to IM nailing with biodegradable implants are of clinical and scientific interest. Task of the study: to substantiate of the use of implants made of biodegradable magnesium alloy MS-10 in the dynamic IM nailing for diaphyseal fractures of the tibia. Materials and methods. The study involved 34 patients with diaphyseal tibial fractures, which resembled surgical treatment (IM nailing). Cannulated intramedullary titanium nails served as a blocking pin. The treatment included closed reposition followed with IM nailing of a tibia. To lock the nail, a screw made of magnesium alloy MS-10 was inserted in a static (round) hole in 16 patients. In 18 patients, a screw made of titanium was inserted into a static hole. The both groups passed blood sampling for studies, before and after the surgery, 2 and 4 weeks, 2 and 4 months after surgery. Biochemical blood tests were to determine the concentration of fibrinogen-monomer complexes in the blood plasma (β-naphthol test). Results. The study of the activity of AST and ALT found it lower (19 and 29%) in patients with biodegradable screws, compared to the group of patients with IM nailing locked with bioinert screws. The situation was similar with ESR, fibrinogen B and total bilirubin in the blood of patients in both groups. Conclusions. The study convincingly proves the expediency of the use of biodegradable material (magnesium alloy MS-10) to produce implants for the IM nailing for the patients with long bones’ fractures.

Download Full-text

Personification of infusion therapy in patients with ischemic stroke depending on the severity of the violation of energy-structural status

Infusion & Chemotherapy ◽

10.32902/2663-0338-2020-3.1-60 ◽

2020 ◽

pp. 73-73

Author(s):

K.V. Serikov ◽

G.A. Shifrin ◽

L.M. Smyrnova

Keyword(s):

Ischemic Stroke ◽

Intensive Therapy ◽

City Council ◽

Infusion Therapy ◽

City Hospital ◽

Non Profit ◽

Results Of Treatment ◽

Fluid Requirement ◽

Consumption Index ◽

Subsequent Administration

Objective. To determine the tactics of infusion therapy in patients with ischemic stroke (IS) depending on the severity of the violation of energy-structural status (ESST). Materials and methods. A study of 32 patients with severe IS on the National Institutes of Health Stroke Scale (16,7±1,5), who were in the department of anesthesiology with intensive therapy units of the Municipal Non-Profit Enterprise «City Hospital № 9» Zaporizhzhia City Council. Of these, 11 were men (34,4 %; the average age – 68,2±2,5 years), 21 were women (65,6 %; average age – 72,1±1,6). Results and discussion. In patients with IS, disorders ESST were defined as hyperergic damage at values of cardiac index (CI) of 4,45-5,09 L×min-1×m-2 and oxygen consumption index (IVO2) 186-210 ml×min-1×m-2, and at values of CI ≥5,10 L×min-1×m-2 and IVO2 ≥211 ml×min-1×m-2 – as hyperergic insufficiency. While hypoergic damage ESST occurred at values of CI 2,33-1,82 L×min-1×m-2 and IVO2 104-85 ml×min-1×m-2, and at CI ≤1,81 L×min-1×m-2 and IVO2 ≤84 ml×min-1×m-2 hypoergic insufficiency of ESST was observed. The daily fluid requirement of a patient with IS was calculated according to the formula 4+2+1: for the first 10 kg of weight – 4 ml×kg-1×h-1; from 11 to 20 kg – 2 ml×kg-1×h-1; from 21 kg – on 1 ml×kg-1×h-1 (Park G.R., Roe P.G., 2005; Netyazhenko V.Z., Halushko O.A., 2012). Infusion therapy in patients with IS and hyperergic damage ESST was performed with 0,9 % sodium chloride solution according to the formula 4+2+1 on the background of the use of esmolol intravenously bolus 250 mg and subsequent administration of 50 mсg×kg-1×min-1, and in hyperergic insufficiency 500 mg of esmolol intravenously bolus and subsequent administration of 100 mсg×kg-1×min-1. While in hypoergic damage ESST on the background of infusion therapy used dopamine or dobutamine 1-5 mсg×kg-1×min-1, and in hypoergic insufficiency, the dose of dopamine or dobutamine was increased to achieve the desired effect. Conclusions. The personification of infusion therapy depending on the severity of the violation of ESST can improve the results of treatment of patients with IS in the most acute period.

Download Full-text

Experience in treatment of specific complications of blocked intramedullary osteosynthesis in diaphyseal fractures of the femur

Practical medicine ◽

10.32000/2072-1757-2018-7-58-61 ◽

2018 ◽

Vol 16 (7(part 1)) ◽

pp. 58-61

Author(s):

R. A. Shafigulin ◽

◽

R. Ya. Khabibyanov ◽

Keyword(s):

Intramedullary Osteosynthesis ◽

Diaphyseal Fractures ◽

Fractures Of The Femur

Download Full-text

Fatigue Properties of AZ31B Magnesium Alloy Processed by Equal-Channel Angular Pressing

Metals ◽

10.3390/met11081191 ◽

2021 ◽

Vol 11 (8) ◽

pp. 1191

Author(s):

Ryuichi Yamada ◽

Shoichiro Yoshihara ◽

Yasumi Ito

Keyword(s):

Magnesium Alloy ◽

Equal Channel Angular Pressing ◽

Low Cycle Fatigue ◽

Annealed Sample ◽

Fatigue Tests ◽

Fatigue Properties ◽

Angular Pressing ◽

Fundamental Research ◽

Number Of Cycles ◽

Biodegradable Magnesium

A stent is employed to expand a narrowed tubular organ, such as a blood vessel. However, the persistent presence of a stainless steel stent yields several problems of late thrombosis, restenosis and chronic inflammation reactions. Biodegradable magnesium stents have been introduced to solve these problems. However, magnesium-based alloys suffer from poor ductility and lower than desired fatigue performance. There is still a huge demand for further research on new alloys and stent designs. Then, as fundamental research for this, AZ31 B magnesium alloy has been investigated for the effect of equal-channel angular pressing on the fatigue properties. ECAP was conducted for one pass and eight passes at 300 °C using a die with a channel angle of 90°. An annealed sample and ECAP sample of AZ31 B magnesium alloy were subjected to tensile and fatigue tests. As a result of the tensile test, strength in the ECAP (one pass) sample was higher than in the annealed sample. As a result of the fatigue test, at stress amplitude σa = 100 MPa, the number of cycles to failure was largest in the annealed sample, medium in the ECAP (one pass) sample and lowest in the ECAP (eight passes) sample. It was suggested that the small low cycle fatigue life of the ECAP (eight passes) sample is attributable to severe plastic deformation.

Download Full-text