Activation of Reparative Osteogenesis by Means of Ultrasonic Action in Treatment of Open Fractures

Violation of reparative regeneration of bone tissue in treatment of open fractures is an urgent problem [1,2]. The frequency of unsatisfactory results of the treatment of these fractures remains high (30%) [3]. The main factors of bone regeneration disorders in conditions of open fractures are following: damage to soft tissue, soft tissue tropism violation, violation of bone trophic and infectious agents from entering into the injury site. The main method of surgical treatment of open fractures of long bones is transosseous osteosynthesis. However, isolated use of external fixation does not solve all the problems of an open fracture [4]. The presence of two or more adverse factors (presence of wounds, crushing of soft tissue, bone defect, infection) is an indication for stimulation of reparative osteogenesis. [3] Stimulation may be accomplished by a variety of factors, including methods using physical impact, in particular ultrasound [5-10]. Ultrasonic vibrations passing through the soft tissue are damped [7]. Therefore, the larger the array of soft tissue to bone is, the lower is the intensity of ultrasonic vibrations reaching the bone and the less the effect of ultrasound. Obviously, the closer is the ultrasonic transducer to the bone; the greater is the effect of ultrasonic treatment.