唑来膦酸对老年桡骨远端骨折术后疗效观察

Effect of Zoledronic Acid on the Healing of Distal Radial Fracture

目的观察唑来膦酸对老年桡骨远端骨折的术后疗效。方法分析自2012年1月1日至2012年12月31日行桡骨远端骨折手术患者136例接受手术治疗并纳入研究,118例获得随访（87%）,分成唑来膦酸组（A组,59例）和对照组（B组,59例）。唑来膦酸组平均年龄（73.09±5.04）岁,男12例,女47例,术后2～7 d使用唑来膦酸抗骨质疏松治疗,并常规补充钙剂和骨化三醇;对照组平均年龄（73.25±6.96）岁,男14例,女45例,术后2～7 d使用针剂密盖息抗骨质疏松治疗,出院后继续使用密盖息鼻喷剂至术后3个月,常规补充钙剂和骨化三醇,术后4周、3个月随访骨折愈合的情况及术后1年复查骨密度的情况。结果老年桡骨远端骨折患者使用唑来膦酸抗骨质疏松药物后骨折愈合无明显影响且腕关节功能改善,术后1年骨密度较前增加。结论发生桡骨远端骨折的老年骨质疏松患者使用唑来膦酸药物后骨质疏松治疗效果好,同时对骨质疏松性桡骨远端愈合无明显不利影响。

Objective To observe the effect of zoledronic acid on distal radius fractures in elderly patients after operation. Methods Analysis of 136 cases of distal radius fractures underwent operation in our hospital from January 1,2012 to Decem-ber 31,2012,118 patients were followed up（87% ）,Patients were divided into zoledronic acid group（group A,59 patients） and control group（group B,59 patients）,group A with an average age of 73. 09 ± 5. 04,12 male patients,47 female patients, postoperative second to seventh day with anti osteoporosis treatment of zoledronic acid,and a conventional calcium and calcitri-ol supplement,B group with an average age of 73. 25 ± 6. 96,male 14 patients,female patient 45,postoperative second to sev-enth day with anti osteoporosis treatment of Injection of Miacalcic,continue using of Miacalcic nasal spray from discharge to postoperative 3 months,and a conventional calcium and calcitriol supplement,4 week and 3 month follow-up of fractures heal-ing and postoperative 1 year follow-up of bone mineral density. Results The fracture healing in elderly patients with no obvi-ous effect of zoledronic acid anti osteoporosis medicine after distal radius fracture,callus in A group is more than callus in group B,postoperative bone mineral density increased over one year ago. Conclusion The effect of osteoporosis treatment with zoledronic acid medicine in elderly patients with distal radius fractures is significant,while no obvious negative effect on the healing of the osteoporotic distal radius fracture.