摘要
目的 探究双膦酸盐联合万向锁定钢板治疗绝经期桡骨粉碎性骨折的近远期疗效。方法 选取2016年1月至2017年1月接受治疗的绝经期桡骨远端粉碎性骨折患者80例,试验是单盲、随机的,采用抽签方法随机等分为A组(万向锁定钢板治疗)和B组(双膦酸盐+万向锁定钢板治疗),观察2组患者近远期疗效和并发症情况及术后12个月血清骨折愈合指标表达情况。结果 2组患者术前、术后即刻、术后1周VAS评分、Broberg和Morrey评分、掌倾角、尺偏角、桡骨缩短、关节面台阶、Gartland-Werley评分和握力均差异无统计学意义(P>0.05);B组患者术后3个月、6个月和12个月的各项指标均显著优于A组,差异有统计学意义(P<0.05);B组患者远期(术后3~12个月)并发症发生率[2.5%(1/40)]显著低于A组[20.0%(8/40)],差异有统计学意义(χ^2=6.135,P=0.013);2组患者术后12个月碱性磷酸酶(BALP)、I型胶原交联羧基末端肽(PICP)、骨钙素(BGP)和骨保护素(OPG)均显著升高,但B组显著高于A组,差异有统计学意义(P<0.05)。结论 双膦酸盐联合万向锁定钢板内固定治疗围绝经期桡骨远端粉碎性骨折患者远期疗效较佳,近期疗效不显著,减少远期并发症的发生,促进骨折愈合标志物的表达。
Objective To explore the short-term and long-term curative effects of bisphosphonate combined with universal locking plate in the treatment of comminuted radial fracture in menopausal patients.Methods Eighty patients with comminuted fracture of distal radius who received treatment in our hospital from January 2016 to January 2017 were enrolled in this single-blind randomized study.They were randomly divided into group A(universal locking plate treatment)and group B(bisphosphonate+universal locking plate treatment)by drawing lots.The short-term and long-term curative effects and complications of the two groups were observed,and the expression of serum indicators in fracture healing of both groups was observed at 12 months after operation.Results There were no significant differences in VAS scores,Broberg and Morrey scores,palm tilt angle,ulnar angle,tibia shortening,presence of steps in articular surface,Gartland-Werley score,and grip strength between the two groups before surgery,immediately after surgery,and 1 week after surgery.(P>0.05).The above indexes of patients in group B were significantly better than those in group A at 3,6 and 12 months postoperatively,and the difference was statistically significant(P<0.05).The incidence of long-term complications(3~12 months after surgery)was 2.5%(1/40)which was significantly lower than that 20.0%(8/40)in group A,and the difference was statistically significant(χ^2=6.135,P=0.013).Bone alkaline phosphatase(BALP),procollagen type I C-terminal propeptide(PICP),osteocalcin(BGP)and osteoprotegerin(OPG)were significantly elevated in the two groups after surgery,and those in group B was significantly higher as compared with group A.The difference was statistically significant(P<0.05).Conclusion The long-term curative effect of bisphosphonate combined with universal locking plate fixation is favorable for peri-menopausal comminuted fracture of the distal radius.The short-term effect is not significant,which reduces the occurrence of long-term complications and promotes the expression of serum indicators for fracture healing.
作者
李建林
吴文侠
云丽媛
LI Jianlin;WU Wenxia;YUN Liyuan(Department of Osteology,Laoting County Hospital,Hebei,Laoting 2018383,China)
出处
《河北医药》
CAS
2019年第19期2922-2925,共4页
Hebei Medical Journal
基金
河北省中医药管理局计划项目(编号:2018383)
关键词
双膦酸盐
万向锁定钢板
绝经期桡骨远端粉碎性骨折
近远期疗效
bisphosphonate
universal locking plate
menopausal comminuted fracture of the distal radius
short-term and long-term curative effects
