Immune Response and Bone Metabolism During Recovery from Fractures of the Lower

Relevance of the study. Deep infections (osteomyelitis, infection of soft tissues) reach 15-25% after open fractures of the lower leg and 5-10% with fractures of the hip. Non-fusion or prolonged delayed fusion is observed in 8-17% of cases of long bone fractures, especially in open and multiple injuries. Immune-inflammatory factors play an important role in bone regeneration: excessive inflammation can hinder healing, while an adequate immune response promotes repair. Markers like CRP reflect inflammatory activity, and indicators of bone metabolism (vitamin D, osteocalcin) reflect the intensity of osteogenesis. Exclusion criteria: systemic bone diseases (severe osteoporosis, hyperparathyroidism), immunosuppressive therapy, oncopathology. The patients were retrospectively divided into groups: the main group consisted of 20 patients with a complicated course (infection in the fracture area and/or non–fusion developed over a period of >8 months); the comparison group consisted of 52 patients with successful fracture healing within the standard time frame; the control group (reference group) consisted of 10 practically healthy individuals. The groups were compared according to a number of indicators. The level of CRP, total IgG and IgA, 25(OH)vitamin D, osteocalcin, alkaline phosphatase, as well as clinical markers of healing (X-ray evaluation of bone formation) were studied in all patients during the dynamics (1st, 2nd, 4th, 8th and 12th weeks after injury). calluses). Statistical analysis included the t-test for independent samples and χ2 for fractions, differences were considered significant at p