有限接触动力加压钢板内固定植骨术治疗四肢骨折创伤后骨不连的效果及对IGF-1、FGF-2的影响

Effect of Limited Contact Power Compression Plate Internal Fixation Implantation in the Treatment of Post-traumatic Bone Nonunion of Extremity Fractures and Its Influence on IGF-1 and FGF-2

目的:探讨有限接触动力加压钢板内固定植骨术治疗四肢骨折创伤后骨不连的效果及对胰岛素样生长因子-1(IGF-1)、成纤维细胞生长因子-2(FGF-2)的影响。方法:选取2020年5月-2022年2月于华中科技大学协和江北医院诊治的102例四肢骨折创伤后骨不连患者,采用随机数字表法将其分为观察组(n=51)及对照组(n=51)。对照组行锁定加压钢板内固定植骨术,观察组行有限接触动力加压钢板内固定植骨术。对比两组的手术相关指标、Ⅰ型胶原羧基端肽β特殊序列(β-CTX)及核因子-κB受体活化因子配体(RANKL)、相关生长因子及并发症发生情况。结果:观察组手术切口长度、骨折愈合时间、住院时间均短于对照组,术中出血量少于对照组(P<0.05)。两组手术时间比较,差异无统计学意义(P>0.05)。术前,两组β-CTX及RANKL水平比较,差异均无统计学意义(P>0.05);术后4周,两组β-CTX及RANKL水平均低于术前,且观察组均低于对照组(P<0.05)。术前,两组IGF-1、FGF-2水平比较,差异均无统计学意义(P>0.05);术后4周,两组IGF-1、FGF-2水平均高于术前,且观察组均高于对照组(P<0.05)。观察组并发症发生率为1.96%,低于对照组的13.73%(P<0.05)。结论:有限接触动力加压钢板内固定植骨术治疗四肢骨折创伤后骨不连可改善患者的骨代谢状态,减少并发症,安全有效,值得临床应用及推广。

Objective:To investigate the effect of limited contact power compression plate internal fixation implantation in the treatment of post-traumatic bone nonunion of extremity fractures and its Influence on insulinlike growth factor-1(IGF-1)and fibroblast growth factor-2(FGF-2).Method:A total of 102 patients with posttraumatic bone nonunion of extremity fractures treated at Huazhong University of Science and Technology Union Jiangbei Hospital from May 2020 to February 2022 were selected,they were divided into observation group(n=51)and control group(n=51)according to the random number table method.The control group underwent internal fixation with locking compression plates and the observation group underwent limited contact power compression plate internal fixation implantation.The surgical related indexes,typeⅠcollagen carboxy-terminal peptideβspecial sequence(β-CTX)and nuclear factor-κB receptor-activating factor ligand(RANKL),related growth factors and complications of the two groups were compared.Result:Incision length,fracture healing time and hospital stay in the observation group were shorter than those in the control group,intraoperative blood loss was less than that in the control group(P<0.05).There was no significant difference in surgical time between the two groups(P>0.05).Before surgery,there were no significant differences inβ-CTX and RANKL levels between the two groups(P>0.05);4weeks after surgery,β-CTX and RANKL levels in both groups were lower than those before surgery,those in the observation group were lower than those in the control group(P<0.05).Before surgery,there were no significant differences in the levels of IGF-1 and FGF-2 between the two groups(P>0.05);4 weeks after surgery,IGF-1 and FGF-2 levels in both groups were higher than those before surgery,those in the observation group were higher than those in the control group(P<0.05).The complication rate in the observation group was 1.96%,which was lower than 13.73%in the control group(P<0.05).Conclusion:Limited contact power compression plate internal fixation implantation for post-traumatic bone nonunion of extremity fractures can improve the bone metabolic status of patients,reduce complications,and is safe and effective worthy of clinical application and promotion.