Динаміка біохімічних маркерів кісткового метаболізму у пацієнтів із сегментарними дефектами кісток під час лікування за методикою Masquelet

Segmental bone defects represent a complex clinical challenge in reconstructive orthopedics, etiologically associated with high-energy trauma, oncological resections, and osteomyelitic processes. The two-stage Masquelet technique with induced membrane formation demonstrates high efficacy in reconstructing critical-size bone defects, however, the molecular biochemical mechanisms of reparative osteogenesis during its application remain insufficiently investigated. Objective. To evaluate the dynamics of biochemical markers of bone metabolism in patients with segmental defects of long tubular bones during treatment using the induced membrane (Masquelet) technique in order to determine the metabolic characteristics of osteogenesis and to optimize bone regeneration. Methods. The study included 85 patients aged 18 to 65 years. The experimental group consisted of 44 patients with segmental bone defects, while the control group comprised 41 patients with low-energy fractures. Biochemical markers such as alkaline phosphatase, osteocalcin, β-CrossLaps, calcium, phosphorus, and parathyroid hormone were analyzed. Results. Before treatment, significant abnormalities in bone metabolism markers were observed in the experimental group: elevated alkaline phosphatase (175.45 ± 46.2) U/L, osteocalcin (53.70 ± 12.4) ng/mL, β-CrossLaps (0.949 ± 0.271) ng/mL. Following treatment, 75-92 % of patients demonstrated normalization of biochemical parameters, indicating stimulation of reparative osteogenesis. Conclusions. The Masquelet technique effectively stimulates bone regeneration in segmental defects, as confirmed by the normalization of biochemical markers. Comprehensive biochemical monitoring can serve as a valuable tool for assessing treatment efficacy.