髓内钉与钢板内固定治疗胫骨骨折的效果及对骨代谢与炎症因子水平的影响  

Effect of Intramedullary Nailing and Plate Fixation on Tibial Fractures and Their Effects on Bone Metabolism and Inflammatory Factors

作　　者：吕利雄 廖彩佶 黄云 LYU Lixong;LIAO Caijie;HUANG Yun(Department of external surgery,The third people's hospital of baiyun district,Guangzhou city,Guangzhou,Guangdong 510545)

机构地区：[1]广州市白云区第三人民医院外一科,广东广州510545

出　　处：《中国伤残医学》2024年第8期43-46,共4页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探讨髓内钉与钢板内固定治疗胫骨骨折的效果及对骨代谢与炎症因子水平的影响.方法:回顾性分析2018年1月—2020年12月于我院进行治疗的60例胫骨骨折患者资料,根据治疗术式的不同将其分为锁定加压钢板(LCP)组和交锁髓内钉(IMN)组,各30例.LCP组使用LCP治疗,IMN组使用IMN治疗.对比2组的临床疗效、术后恢复情况、骨代谢与炎症因子水平、手术并发症情况.结果:IMN组治疗总有效率为93.33%,高于对照组的73.33%,差异有统计学意义(P<0.05).IMN组的手术、开始下地负重、骨折愈合时间均短于LCP组,手术出血量多于LCP组,术后1、3个月的Olerud和Molander|踝关节骨折疗效评分系统、改良美国特种外科医院膝关节评分系统评分均高于LCP组,组间差异有统计学意义(P<0.05).IMN组的骨钙素、破骨细胞抑制因子、Ⅰ型原胶原N-端前肽均高于LCP组,尿脱氧吡啶酚、耐酒石酸酸性磷酸酶、组织蛋白酶K均低于LCP组,IMN组的白细胞介素-35、转化生长因子-β高于LCP组,肿瘤坏死因子-α、γ干扰素均低于LCP组,组间差异有统计学意义(P<0.05).结论:IMN治疗胫骨骨折的效果要优于LCP,术后恢复情况更好,有利于骨代谢与炎症因子水平的改善.Objective:To investigate the effect of intramedullary nail and plate fixation on tibial fracture and the effect on bone metabolism and inflammatory factors.Methods:The data of 60 patients with tibial fracture treated in our hospital from January 2018 to December 2020 were retrospectively analyzed,and they were divided into locking compression plate(LCP)group and interlocking intramedullary nail(IMN)group,with 30 cases each,according to different treatment methods.The LCP group was treated with LCP and the IMN group was treated with IMN.The clinical efficacy,postoperative recovery,bone metabolism and inflammatory factor levels,and operative complications were compared between the two groups.Results:The effective rate of IMN group was 93.33%,which was higher than 73.33%of control group,the difference was statistically significant(P<0.05).In IMN group,the operation,starting weight bearing and fracture healing time were all shorter than those in LCP group,the amount of surgical bleeding was more than that in LCP group,and the scores of Olerud and Molanderl ankle fracture efficacy scoring system and the modified American Hospital for Special Surgery Knee Scoring system were all higher than those in LCP group 1 and 3 months after operation,the differences between groups were statistically significant(P<0.05).The levels of osteocalcin,osteoclast inhibitory factor and protocollagen type I N-terminal propeptide in IMN group were higher than those in LCP group,urinary deoxypyridinol,tartrateresistant acid phosphatase and cathepsin K were lower than those in LCP group,and the levels of interleukin-35 and transforming growth factor-βin IMN group were higher than those in LCP group.Tumor necrosis factor-αand gamma interferon were lower than LCP group,and the differences were statistically significant(P<0.05).Conclusion:IMN is better than LCP in the treatment of tibial fracture the recovery was better,which was conducive to the improvement of bone metabolism and inflammatory factors.

关 键 词：胫骨骨折 交锁髓内钉 锁定加压钢板 骨代谢 

分 类 号：R687.3[医药卫生—骨科学]