微型空心螺钉对末节指骨远端骨折患者术后指功能、OPG/RANK/RANKL水平的影响  

Effect of miniature hollow screws on postoperative finger function and OPG/RANK/RANKL levels in patients with distal phalangeal fractures

作　　者：邵旭辉 王冠军 王登基 SHAO Xu-hui;WANG Guan-jun;WANG Deng-ji(Puyang TCM Hospital,Puyang Henan 457000,China)

机构地区：[1]濮阳市中医医院骨八科,河南濮阳457000

出　　处：《医药论坛杂志》2023年第6期40-44,共5页Journal of Medical Forum

摘　　要：目的 探究微型空心螺钉治疗末节指骨远端骨折(DPF)患者的效果。方法 选取濮阳市中医医院2019年5月—2022年9月94例DPF患者,按随机数字表法分成A组(n=47)、B组(n=47)。B组接受克氏针内固定(KWIF)治疗,A组接受微型空心螺钉内固定治疗。对比2组骨折愈合率、患指功能优良率、手术前后血清护骨素-核因子κB受体活化因子-核因子κB受体活化因子配体(OPG/RANK/RANKL)水平、应激指标[P物质(SP)、白细胞介素-6(IL-6)、降钙素原(PCT)、前列腺素E2(PGE2)]水平、并发症发生率。结果 与B组骨折愈合率80.85%(38/47)相比,A组95.74%(45/47)更高(P<0.05);与B组相比,A组术中透视次数更少,手术耗时更短(P<0.05);与B组患指功能优良率70.21%(33/47)相比,A组91.49%(43/47)更高(P<0.05);与B组对比,术后1个月、3个月A组血清OPG水平更高,血清RANK、RANKL水平更低(P<0.05);与B组相比,术后1 d、3 d A组血清SP、IL-6、PCT、PGE2水平更低(P<0.05);与B组并发症总发生率17.02%(8/47)相比,A组2.13%(1/47)更低(P<0.05)。结论 与KWIF治疗DPF患者相比,应用微型空心螺钉治疗可有效优化手术指标,提高患指功能,调节OPG/RANK/RANKL系统,促进骨折愈合,减少并发症,且对机体产生应激反应更小。Objective To investigate the effectiveness of miniature hollow screws in the treatment of patients with distal phalangeal fractures(DPF).Methods Ninety-four patients with DPF in our hospital from May 2019 to September 2022 were selected and divided into group A(n=47) and Group B(n=47) according to random number table method.Group B was treated with KWIF,and group A was treated with miniature hollow screw.The rate of fracture healing,the excellent rate of function of the affected finger,serum osteoprotegerin-nuclear factor κB receptor activating factor-nuclear factor κB receptor activating factor ligand(OPG/RANK/RANKL) level,stress index [Substance P(SP),interleukin-6(IL-6),procalcitonin(PCT),prostaglandin E2(PGE2)] level,complication rate before and after operation were compared between the two groups.Result The fracture healing rate was higher in group A [(95.74%(45/47)] compared with group B [80.85%(38/47)](P<0.05);the number of intraoperative fluoroscopies was less and the operative time was shorter in group A compared with group B(P<0.05);the functional excellence rate of the affected finger was higher in group A [91.49%(43/47)] compared with group B [70.21%(33/47)](P<0.05).Compared with group B,serum OPG levels were higher and serum RANK and RANKL levels were lower in group A at 1 month and 3 months postoperatively(P<0.05);serum SP,IL-6,PCT,and PGE2 levels were lower in group A at 1 d and 3 d postoperatively compared with group B(P<0.05);and the overall complication rate [2.13%(1/47)] was lower in group A compared with group B [17.02%(8/47)](P<0.05).Conclusion Compared with KWIF for patients with DPF,the application of miniature hollow screw treatment can effectively optimize the surgical index,improve the function of the affected finger,regulate the OPG/RANK/RANKL system,promote fracture healing,reduce complications,and produce less stress on the organism.

关 键 词：微型空心螺钉 指功能 末节指骨远端骨折 应激 

分 类 号：R683.41[医药卫生—骨科学]