Guo Rui-Feng, Zheng Jia
Department of Orthopaedics, the People's Hospital of Puyang, Puyang 457000, Henan, China;
Department of Orthopaedics, the People's Hospital of Puyang, Puyang 457000, Henan, China.
Zhongguo Gu Shang. 2019 Dec 25;32(12):1117-1122. doi: 10.3969/j.issn.1003-0034.2019.12.010.
To analyze the level of serum N-terminal propeptide of type I precollagen (PINP) and tartrate resistant acid phosphatase 5b(TRACP-5b) in patients with femoral neck fracture(FNF) after minimally invasive anterior lateral approach with total hip arthroplasty and the effects of hip function.
From September 2016 to May 2017, 98 cases of femoral neck fracture were divided into control group and observation group, 49 cases in each group. There were 49 patients in control group, including 30 males and 19 females, ranging in age from 63 to 72 years old, who underwent minimally invasive anterolateral total hip arthroplasty. There were 49 patients in observation group, including 29 males and 20 females, ranging in age from 62 to 73 years old, who underwent minimally invasive anterolateral total hip arthroplasty. The perioperative conditions(operation time, bleeding volume, incision length, hospitalization time), bone metabolism indexes including PINP, TRACP-5b, fibroblast growth factor(FGF), bone gla-protein(BGP), propetide carboxy-terminal procollagen (PICP), bone-specific alkaline phosphatase(BAP), and pain mediators such as prostaglandin E2 (PGE2) and 5-hydroxytrytamine (5-HT) levels were compared between the two groups. The hip joint function and complications were evaluated.
The operation time of the observation group was longer than that of the control group(<0.05); there was no significant difference in bleeding volume, incision length and hospitalization time between two groups(>0.05). PINP, fibroblast growth factor, BGP, PICP and BAP in observation group were higher than those in control group 1 month after operation, and TRACP-5b was lower than those in control group(<0.05); PGE2 and 5-HT in observation group 1 month after operation were lower than those before operation, and lower than those in control group(<0.05). The excellent and good rate of hip function in observation group was higher than that in control group (<0.05), and the incidence of complications was not significantly different from that in the control group (>0.05).
Minimally invasive anterolateral approach total hip arthroplasty is safe and reliable, and can improve hip function, improve bone metabolism, promote fracture healing, alleviate pain in patients with femoral neck fracture, which is worthy of promotion.
分析股骨颈骨折（FNF）患者采用微创前外侧入路全髋关节置换术后血清I型前胶原氨基端前肽（PINP）和抗酒石酸酸性磷酸酶5b（TRACP-5b）水平及对髋关节功能的影响。
选取2016年9月至2017年5月98例股骨颈骨折患者，分为对照组和观察组，每组49例。对照组49例，男30例，女19例，年龄63～72岁，行微创前外侧全髋关节置换术。观察组49例，男29例，女20例，年龄62～73岁，行微创前外侧全髋关节置换术。比较两组围手术期情况（手术时间、出血量、切口长度、住院时间）、骨代谢指标包括PINP、TRACP-5b、成纤维细胞生长因子（FGF）、骨钙素（BGP）、前肽羧基端前胶原（PICP）、骨特异性碱性磷酸酶（BAP），以及疼痛介质如前列腺素E2（PGE2）和5-羟色胺（5-HT）水平。评估髋关节功能及并发症情况。
观察组手术时间长于对照组（<0.05）；两组出血量、切口长度及住院时间比较差异无统计学意义（>0.05）。术后1个月观察组PINP、成纤维细胞生长因子、BGP、PICP及BAP高于对照组，TRACP-5b低于对照组（<0.05）；术后1个月观察组PGE2及5-HT低于术前，且低于对照组（<0.05）。观察组髋关节功能优良率高于对照组（<0.05），并发症发生率与对照组比较差异无统计学意义（>0.05）。
微创前外侧入路全髋关节置换术安全可靠，可改善股骨颈骨折患者髋关节功能，改善骨代谢，促进骨折愈合，减轻疼痛，值得推广。
