Bone turnover markers in patients with isolated femoral shaft fracture undergoing systemic ozone therapy

Osikov MV, Davydova EV, Abramov KS
About authors

South Ural State Medical University, Chelyabinsk, Russia

Correspondence should be addressed: Mikhail V. Osikov
Vorovskogo, 64, Chelyabinsk, 454092; ur.xednay@vokiso.forp

About paper

Author contribution: Osikov MV conceived the study, proposed its design, analyzed the obtained data, wrote and edited the manuscript; Davidova EV conceived the study, proposed its design, analyzed the obtained data, participated in writing the manuscript; Abramov KS collected clinical data, analyzed the results of the study, wrote and edited the manuscript. The authors equally contributed to the study and preparation of the manuscript, read and approved the final version of this article before publication.

Compliance with ethical standards: the study was approved by the Ethics Committee of the South Ural State Medical University, Chelyabinsk (Protocol № 4 dated May 22, 2020). Informed consent was obtained from all study participants.

Received: 2020-12-29 Accepted: 2021-01-17 Published online: 2021-02-02

Efferent physical therapy holds promise as an adjunct to the combination treatment of femoral fractures in young, working-age individuals. The aim of the study was to investigate the dynamics of bone turnover markers at different stages of femoral fracture consolidation in patients undergoing ozone therapy. The study enrolled 20 men (group 2, 47.8 ± 3.5 years) with a femoral shaft fracture (AO/ASIF 32А, 32В). The control group (group 1, 46.8 ± 3.7 years) comprised 10 healthy males. Subgroup 2a (n = 10) was assigned to receive standard therapy; subgroup 2b (n = 10) was assigned to receive standard therapy complemented by minor autohemotherapy (MAHT) at 20 mg/L ozone concentrations. On days 7, 30 and 90, fracture consolidation was assessed on the RUST scale and blood levels of С-terminal telopeptides of type I collagen (bCTx, pg/ml) and procollagen type I carboxy-terminal propeptide (PICP, ng/ml) were measured. On day 7, the total RUST score in subgroups 2a and 2b was 4 points; on day 30, it was 6.5 and 8.7 points, respectively, and on day 90, it reached 10 and 11.5 points, respectively. Bone mineral density was as high as 90% in the MAHT subgroup vs. 78% in subgroup 2а, indicating faster bone healing. On day 30, bCTx levels in subgroup 2b were higher than in subgroup 2a (2289.4 [2145.3; 2365.4] vs. 1894.6 [1745.3; 2098.2], respectively. On day 7, PICP was significantly elevated in subgroup 2b in comparison with subgroup 2a; its levels peaked on days 30 and 90 (day 30: 268.3 [231.2; 286.3] vs. 183.2 [174.6; 195.6]; day 90: 584.6 [512.3; 589.3] vs. 351.2 [312.3; 369.4]. Thus, MAHT produces a positive effect on the quality and intensity of bone healing in men with isolated closed femoral shaft fractures.

Keywords: ozone therapy, closed isolated femoral shaft fracture, bone remodeling