股骨近端髓内钉治疗不稳定型股骨粗隆间骨折的疗效
Therapeutic Effects of the Proximal Femoral Nail for the Treatment of Unstable Intertrochanteric Fractures.
作者信息
Cai Yuwei, Zhu Wenjun, Wang Nan, Yu Zhongxiang, Chen Yu, Xu Shengming, Feng Juntao
机构信息
Department of Orthopedics, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200120, China.
Department of Traditional Chinese Medicine, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai 201619, China.
出版信息
Evid Based Complement Alternat Med. 2022 Sep 2;2022:1001354. doi: 10.1155/2022/1001354. eCollection 2022.
OBJECTIVE
The aim of this study was to analyze the clinical effect of the proximal femoral nail on elderly patients with unstable intertrochanteric fracture and the effect of the proximal femoral nail on serum levels of matrix metalloproteinases (MMPs) and osteoprotegerin (OPG).
METHODS
The elderly patients with unstable intertrochanteric fracture of the femur admitted to our hospital from January 2017 to January 2021 were studied. 100 patients were randomly divided into two groups: the control group ( = 50) and the observation group ( = 50). The patients in the control group were treated with a proximal femoral locking compression plate. The patients in the observation group were treated with the proximal femoral antirotation intramedullary nail. The clinical therapeutic effects of the two groups and the changes in serum MMPs and OPG levels before and after treatment were analyzed.
RESULTS
Compared with the control group, the operation time, postoperative landing time, and fracture healing time of the observation group were significantly shortened, and intraoperative blood loss was significantly reduced ( < 0.05). Compared with the control group, the total effective rate of patients in the observation group was significantly higher ( < 0.05). After treatment, the levels of CRP, IL1, IL2, MMP-2, MMP-6, TIMP-1, and RANKL decreased significantly in both groups ( < 0.05), while the levels of OPG increased significantly ( < 0.05). Compared with the control group, the changes in the above indexes were more obvious in the observation group ( < 0.05).
CONCLUSION
The proximal femoral antirotation intramedullary nail has a better therapeutic effect on elderly patients with unstable intertrochanteric fracture, and the level of MMPs and OPG may be related to the treatment process.
目的
本研究旨在分析股骨近端髓内钉治疗老年不稳定型股骨转子间骨折的临床效果以及对血清基质金属蛋白酶（MMPs）和骨保护素（OPG）水平的影响。
方法
对2017年1月至2021年1月我院收治的老年不稳定型股骨转子间骨折患者进行研究。100例患者随机分为两组：对照组（n = 50）和观察组（n = 50）。对照组患者采用股骨近端锁定加压钢板治疗。观察组患者采用股骨近端抗旋髓内钉治疗。分析两组的临床治疗效果以及治疗前后血清MMPs和OPG水平的变化。
结果
与对照组相比，观察组的手术时间、术后下地时间和骨折愈合时间明显缩短，术中出血量明显减少（P < 0.05）。与对照组相比，观察组患者的总有效率明显更高（P < 0.05）。治疗后，两组患者的CRP、IL1、IL2、MMP - 2、MMP - 6、TIMP - 1和RANKL水平均明显降低（P < 0.05），而OPG水平明显升高（P < 0.05）。与对照组相比，观察组上述指标的变化更明显（P < 0.05）。
结论
股骨近端抗旋髓内钉治疗老年不稳定型股骨转子间骨折疗效更佳，MMPs和OPG水平可能与治疗过程有关。
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