正确开口插髓内钉再复位对闭合复位困难股骨转子间骨折患者复位质量及炎性反应指标的影响

Effects of correct opening and re-reduction of intramedullary nail on the quality of reduction and inflammatory response indexes in patients with femoral intertrochanteric fractures and difficult closed reduction

目的探讨正确开口插髓内钉再复位对闭合复位困难股骨转子间骨折患者复位质量及炎性反应指标的影响。方法选取2018年5月至2020年5月收治的40例闭合复位困难股骨转子间骨折患者,采用抽签法以单双号分组形式将其随机分为对照组(20例,传统复位手术)和观察组(20例,正确开口插髓内钉再复位手术)。比较两组的治疗效果。结果观察组的复位优率显著高于对照组(P<0.05);两组的复位优良率比较,差异无统计学意义(P>0.05)。术后1 d,观察组的IL-6水平显著低于对照组,TGF-β水平显著高于对照组(P<0.05)。术后6个月,两组的髋关节功能各项评分均显著升高(P<0.05)。结论临床治疗闭合复位困难股骨转子间骨折采用正确开口插髓内钉再复位手术能在一定程度上提高复位质量,减轻机体炎性反应,促进髋关节功能恢复,进而取得理想的康复效果。

Objective To explore the effects of correct opening and re-reduction of intramedullary nail on the quality of reduction and inflammatory response indexes in patients with femoral intertrochanteric fractures and difficult closed reduction.Methods A total of 40 patients with femoral intertrochanteric fractures and difficult closed reduction admitted from May 2018 to May 2020 were selected and randomly divided into control group(20 cases,traditional reduction surgery)and observation group(20 cases,correct opening and re-reduction of intramedullary nail surgery)by drawing lots with form of odd and even numbers.The therapeutic effects of the two groups were compared.Results The excellent rate of reduction of the observation group was significantly higher than that of the control group(P<0.05);there was no statistically significant difference in the excellent and good rate of between the two groups(P>0.05).One day after operation,the IL-6 level of the observation group was significantly lower than that of the control group,and the TGF-βlevel was significantly higher than that of the control group(P<0.05).At 6 months after operation,the hip joint function scores of both groups significantly increased(P<0.05).Conclusion In the clinical treatment of femoral intertrochanteric fractures with difficult closed reduction,the correct opening and re-reduction of intramedullary nail surgery can improve the quality of reduction to a certain extent,reduce the inflammatory reaction of the body,promote the recovery of hip joint function,and then achieve an ideal rehabilitation effect.