Wang Ke-Meng, Wei Shi-Ping, Yin Xiao-Yan, Meng Qing-Ju, Kong Yu-Ming
Department of Orthopedics, First Affiliated Hospital of Xingtai Medical College, Xingtai 054001, Hebei Province, China.
Department of Basic Medicine, Xingtai Medical College, Xingtai 054001, Hebei Province, China.
World J Clin Cases. 2022 Jul 26;10(21):7324-7332. doi: 10.12998/wjcc.v10.i21.7324.
Osteoporosis is a global disease affecting 6.6% of the total population. Osteoporosis complications include fractures, increased bone fragility, and reduced bone strength. The most commonly affected parts are the vertebral body, hip, and wrist.
To examine the effect of alendronate sodium combined with InterTan for osteoporotic femoral intertrochanteric fractures on bone and fracture recurrence.
In total, 126 cases of osteoporotic femoral intertrochanteric fractures were selected and divided into two groups according to the 1:1 principle by the simple random method. They were admitted to the Department of Orthopedics, First Affiliated Hospital of Xingtai Medical College, from January 2018 to September 2020. The control group was treated with InterTan fixation combined with placebo, and the observation group with alendronate sodium based on InterTan fixation. Operation-related indicators, complications, and recurrent fractures were compared between the groups. Changes in bone metabolism markers, value for hip bone mineral density, and Harris Hip Score were observed.
Operation time, intraoperative blood loss, postoperative ambulation time, and complications were compared between the groups, and no significant difference was found. The fracture healing time was significantly shorter in the observation group than in the control group. β-Collagen-specific sequence (β-CTX) and total aminoterminal propeptide of type I procollagen (T-PINP) in the control group at 3 mo after operation were compared with those before operation, and the difference was not significant. Six months after the operation, the β-CTX level decreased and T-PINP level increased. β-CTX level at 3 and 6 mo in the observation group after operation was lower, and T-PINP level was higher, than that before operation. Compared with the control group, T-PINP level of the observation group was significantly higher and β-CTX level was significantly lower at 3 and 6 mo after operation. The value of hip bone mineral density was compared in the control group before and 1 mo after operation, and significant difference was not found. Compared with the control group, the value of hip bone mineral density in the observation group was significantly higher at 1, 3, 6, and 12 mo after operation. Compared with the control group, the Harris score of the observation group was significantly higher at 1, 3, 6, and 12 mo after operation. The recurrence rate of fractures in the observation group within 12 mo was 0.00%, which was significantly lower than 6.35% in the control group.
Alendronate sodium combined with InterTan in the treatment of osteoporotic femoral intertrochanteric fractures can increase bone mineral density, improve hip joint function, promote fracture healing, and reduce fracture recurrence.
骨质疏松症是一种全球性疾病，影响着6.6%的总人口。骨质疏松症的并发症包括骨折、骨脆性增加和骨强度降低。最常受影响的部位是椎体、髋部和腕部。
探讨阿仑膦酸钠联合InterTan治疗骨质疏松性股骨转子间骨折对骨及骨折复发的影响。
选取126例骨质疏松性股骨转子间骨折患者，采用简单随机法按1:1原则分为两组。2018年1月至2020年9月入住邢台医学高等专科学校第一附属医院骨科。对照组采用InterTan内固定联合安慰剂治疗，观察组在InterTan内固定基础上加用阿仑膦酸钠治疗。比较两组的手术相关指标、并发症及骨折复发情况。观察骨代谢标志物、髋部骨密度值及Harris髋关节评分的变化。
比较两组的手术时间、术中出血量、术后下床活动时间及并发症，差异无统计学意义。观察组骨折愈合时间明显短于对照组。对照组术后3个月时的β-胶原特殊序列（β-CTX）和I型前胶原氨基端前肽（T-PINP）与术前比较，差异无统计学意义。术后6个月，β-CTX水平降低，T-PINP水平升高。观察组术后3个月和6个月时的β-CTX水平低于术前，T-PINP水平高于术前。与对照组比较，观察组术后3个月和6个月时的T-PINP水平明显升高，β-CTX水平明显降低。比较对照组术前及术后1个月的髋部骨密度值，差异无统计学意义。与对照组比较，观察组术后1、3、6和12个月时的髋部骨密度值明显升高。与对照组比较，观察组术后1、3、6和12个月时的Harris评分明显升高。观察组12个月内骨折复发率为0.00%，明显低于对照组的6.35%。
阿仑膦酸钠联合InterTan治疗骨质疏松性股骨转子间骨折可提高骨密度，改善髋关节功能，促进骨折愈合，降低骨折复发率。
