Effect of femoral calcar cerclage fixation combined with alendronate sodium on bone turnover markers and prognosis of osteoporotic femoral neck fractures
Objective To observe the effect of"candy wire"cerclage fixation on bone turnover markers(BTMs)and prognosis in osteoporotic femoral neck basal fractures treated with femoral calcar cerclage fixation combined with alendronate sodium.Methods From May 2019 to May 2022,a total of 64 eligible patients with osteoporotic femoral neck basal fractures were selected and randomly divided the observation group and control group,with 32 cases per group.Patients in both groups were managed by femoral head replacement surgery and oral medication of calcium carbonate D3 tablets for 3 months after the surgery,and those in the observation group were additionally treated with the"candy wire"fixation procedure for the femoral calcar and continued to take alendronate sodium tablet for 3 months after the surgery.The operation time,intraoperative blood loss,length of surgical incision,time to off-bed activities,and hospital stay were compared between the two groups.The bone mineral density(BMD),serum N-terminal peptide of type Ⅰ collagen(S-PINP),and serum C-terminal telopeptide of type Ⅰ collagen(S-CTX)were compared between the two groups before and after 3 months of treatment.Patients were followed up for 12 months to analyze the improvement of the Harris Hip Scale(HHS)scores,the Visual Analog Scale(VAS)scores,the modified Barthel index(MBI),and postoperative complications.Results There were no significant differences in operation time,intraoperative bleeding,and length of surgical incision between groups(P>0.05).The time to off-bed activities and hospital stay were significantly shorter in the observation group than those of the control group(P<0.05).BTMs of S-PINP and S-CTX increased significantly after the surgery in both groups compared with those before surgery.The bone formation marker of S-PINP in the observation group was significantly higher than that of the control group,and the bone resorption marker of S-CTX was significantly lower than that of the control group(P<0.05).The BMD around the prostheses significantly increased after the surgery compared with that before treatment,which was significantly higher in the observation group than that of the control group(P<0.05).At the 12 months of follow-up,the HHS score and MBI significantly increased than those before surgery,and the VAS score significantly decreased,which were more pronounced in the observation group than those of control group(P<0.05).During the postoperative follow-up period,the incidence of complications in the observation group was significantly lower than that of the control group(P<0.05).Conclusion The combination of"candy wire"cerclage fixation and alendronate sodium can effectively improve the bone turnover after surgery for osteoporotic femoral neck fractures,promote bone remodeling,and provide a more stable environment for femoral stem bone growth,offering a significant therapeutic effect on the prognosis and recovery.
femoral neck fracturefemoral head replacement surgery"candy wire"cerclage fixationosteoporosisbone turnoverprognosiscalcar femoral
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维普
