ABSTRACT
Objective:To analysis the effect of osteoking on fracture healing after internal fixation in patients with femoral neck fracture.Methods:A total of 120 patients with femoral neck fracture treated in Weifang people's Hospital from January 2017 to April 2020 were analyzed retrospectively. All patients underwent inverted triangular fixation with 3 cannulated screws after reduction. According to the condition whether they took osteoking after operation, they were divided into two groups, with 60 in each groups. The control group was treated with traction and rotation closed reduction. If closed reduction failed, open anatomical reduction was performed. The treatment group took osteoking on the basis of the control group. Both groups were observed 3 months and followed up to 9 months after operation. Bone osteotylus growth and fracture healing were evaluated by X-ray or CT. Lumbar vertebral bone density was detected by dual-energy X-ray bone density instrument. Serum amino terminal peptide of type I procollagen (PINP) and serum carboxy-terminal peptide β (β-CTX) of type I collagen were detected by double-antibody sandwich ELISA and competitive ELISA.Results:The fracture healing time of the treatment group was (13.06±2.35) weeks, and that of the control group was (17.75±3.56) weeks, and the difference between the two groups was statistically significant ( t=8.52, P<0.01). During the follow-up period, the fracture healing rate was 93.3% (56/60) in the treatment group and 75.0% (45/60) in the control group, and the difference was statistically significant ( χ2=7.57, P=0.006). The rate of nonunion was 1.7% (1/60) in the treatment group and 5.0% (3/60) in the control group, and there was no significant difference between the two groups ( χ2=1.03, P=0.309). The rate of malunion was 5.0% (3/60) in the treatment group and 20.0% (12/60) in the control group, and the difference was statistically significant (χ 2=6.17, P=0.013). The BMD of the treatment group was significantly higher than that of the same group before operation at 9 months after follow-up [(0.76±0.12) g/cm2 vs. (0.71±0.06) g/cm2; t=2.89, P<0.05]. The level of serum β-CTX at the 3rd month after operation [(186.76 ± 26.23) ng/L vs. (286.05 ± 23.18) ng/L, t=21.97] in the treatment group was significantly lower than that of the control group ( P<0.05), at the 6th month [(252.34 ± 21.58) ng/L vs. (302.52 ± 16.87) ng/L, t=14.19] in the treatment group was significantly lower than that of the control group ( P<0.05). The PINP level at the 3rd month [(37.52 ± 7.59) μg/L vs. (27.59 ± 5.36) μg/L, t=3.56] in the treatment group was significantly higher than that of the control group ( P<0.05), at the 6th month [(30.54 ± 5.63) μg/L vs. (25.63 ± 4.98) μg/L, t=2.36] in the treatment group was significantly higher than that of the control group ( P<0.05). Conclusion:Osteoking can regulate the bone metabolism balance of patients with femoral neck fracture after internal fixation, shorten the fracture healing time and promote fracture healing.
ABSTRACT
Objective:To explore the risk factors for nonunion or malunion after internal fixation of femoral neck fracture.Methods:A retrospective analysis was done of the 140 patients with femoral neck fracture who had been admitted to Department of Traumatology and Orthopedics, Weifang People's Hospital from January 2013 through June 2019. They were 61 males and 79 females, aged from 18 to 65 years (average, 51.3 years). All patients received "inverted triangle" internal fixation with 3 hollow nails after reduction. The univariate analysis was conducted of the 9 factors: age, gender, fracture side, Garden classification, injury-to-operation time, reduction quality, postoperative ambulation with crutches but no weight-bearing, preoperative bone density, and preoperative 25-hydroxyvitamin D3 concentration. Multivariate logistic regression analysis was used for the factors with P<0.05 to identify risk factors. P<0.05 was considered statistically significant. Results:This cohort of 140 patients obtained follow-up for 6 to 12 months (average, 10.8 months). Nonunion or malunion occurred in 25 cases of them (17.86%). The multivariate logistic regression analysis showed that Garden types Ⅲ&Ⅳ ( OR=2.873, 95% CI: 1.027~8.039, P=0.044), non-anatomic reduction ( OR=4.678, 95% CI: 1.133~19.310, P=0.033), postoperative ambulation time with crutches but no weight-bearing <3 months ( OR=0.230, 95% CI: 0.072~0.737, P=0.013), and preoperative 25-hydroxyvitamin D3 concentration<30 ng/mL ( OR=3.718, 95% CI: 1.337~10.341, P=0.012) were the risk factors for nonunion or malunion after internal fixation of femoral neck fracture. Conclusion:The risk factors for nonunion or malunion after internal fixation of femoral neck fracture may be the Garden types Ⅲ&Ⅳ, non-anatomic reduction, postoperative ambulation time with crutches but no weight-bearing <3 months, and preoperative 25-hydroxyvitamin D3 concentration < 30 ng/mL.
ABSTRACT
0.05).CONCLUSION:There is no evidence of impaired JPS in weight-bearing positions in subjects with ACL reconstruction at a mean follow-up of 12 months after surgery compared with subjects with healthy knees.