重组人骨形态发生蛋白-2联合股骨近端髓内钉内固定术治疗老年骨质疏松股骨粗隆间骨折的效果

Effect of recombinant human bone morphogenetic protein-2 combined with proximal femoral nail internal fixation in the treatment of osteoporotic intertrochanteric fractures in the elderly

目的:观察骨质疏松性粗隆间骨折术中于骨折局部植入重组人骨形态发生蛋白-2(rhBMP-2)治疗的效果。方法:选择2020年至2022年包头医学院第一附属医院创伤二科接收的144例患者,均为骨质疏松性粗隆间骨折,采用随机数字表法分为两组,每组72例。对照组给予单纯骨折复位[股骨近端髓内钉系统(PFNa)内固定术],观察组在对照组采用相同手术方式基础上联合术中局部植入rhBMP-2,通过分析两组患者随访期6个月内骨折愈合时间、骨折愈合率、疼痛数字评分(NRS评分)、髋关节功能评分(Harris评分)、死亡率、住院时间等变量数据对比观察患者术前后并发症、不良反应及治疗效果。结果:观察组骨折愈合率,髋关节功能评分均较对照组有所提升(P<0.05);观察组骨折愈合时间与对照组相比显著缩短(P<0.05);观察组并发症发生比率及死亡比率均较对照组降低(P<0.05);疼痛数字评分(NRS评分),住院时间两组之间对比无统计学意义(P>0.05)。结论:PFNa内固定术治疗骨质疏松性粗隆间骨折联合rhBMP-2经加压铰刀钉道植入术治疗效果显著,对促进患者髋关节功能恢复及减少并发症的发生具有较大意义。

Objective:To observe the effect of recombinant human bone morphogenetic protein-2(rhBMP-2)implantation in the treatment of osteoporotic intertrochanteric fracture.Methods:A total of 144 patients with osteoporotic intertrochanteric fractures admitted to the Second Department of Trauma,the First Affiliated Hospital of Baotou Medical College from 2020 to 2022 were selected and divided into two groups by random number table method,with 72 patients in each group.The control group was given simple fracture reduction(PFNa internal fixation).The observation group was combined with intraoperative local implantation of rhBMP-2 on the basis of the same surgical method in the control group.By analyzing the fracture healing time,fracture healing rate,pain digital score(NRS score),hip joint function score(Harris score),mortality,hospitalization time and other variable data of the two groups of patients during the follow-up period of 6 months,the complications,adverse reactions and treatment effects of the patients before and after operation were compared.Results:The fracture healing rate and hip joint function score in the observation group were higher than those in the control group(P<0.05).The fracture healing time of the observation group was significantly shorter than that of the control group(P<0.05).The incidence of complications and mortality in the observation group were lower than those in the control group(P<0.05).There was no significant difference in pain numerical score(NRS score)and hospitalization time between the two groups(P>0.05).Conclusion:Proximal femoral nail antirotation(PFNa internal fixation)is effective in the treatment of osteoporotic intertrochanteric fracture combined with local implantation of rhBMP-2,which is of great significance in promoting the recovery of hip joint function and reducing the occurrence of complications.