Changes in the antioxidant/prooxidant balance in patients with acquired shortening of the lower leg bones at the stages of the Ilizarov lengthening procedure

Abstract

Introduction Optimization of the conditions of distraction osteogenesis using the method of G.A. Ilizarov remains an important challenge to ensure a reduction in the number of complications and an increase in the effectiveness of this technology. The aim of the study was to study the changes in the antioxidant/prooxidant balance in patients with acquired shortening of the lower leg bones at the stages of the Ilizarov lengthening procedure. Methods The antioxidant/prooxidant status was studied in 12 patients with shortening of one of the lower legs resulting from hematogenous osteomyelitis (group 1) and in 13 patients with post-traumatic shortening of one of the lower legs (group 2). The level of peroxidation products, the activity of superoxide dismutase and vitamins E and A in the blood of these patients were assessed in the dynamics of monofocal bone lengthening using the Ilizarov method. Results It was found that in patients with acquired shortening of the shin bones, regardless of the shortening etiology, during surgical lengthening, an increase in the level of peroxidation products in the blood was observed with a decrease in the level of vitamin E and an increase in superoxide dismutase activity. Discussion The data obtained, together with the current findings from fundamental research, allow us to note that the use of antioxidants (AOs) in patients undergoing segment length correction using the Ilizarov technology is possible from two positions. 1. The positive effect of AOs in terms of stimulation of distraction osteogenesis has been proven. 2. AOs have a systemic effect in the regulation of the recovery processes in the paraosseous tissues of the limb segment under lengthening. Conclusion Peroxidation is activated in the course of surgical lengthening of the lower leg bones in patients with acquired shortenings, regardless of the shortening etiology. The use of antioxidants in such patients can specifically inhibit peroxidation, thereby reducing the risk of provoking bone formation disorders.

Keywords

• shortening of limb bones
• distraction osteogenesis
• ilizarov method
• antioxidants