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降钙素促进老年患者复杂性胫骨平台骨折锁定钢板治疗后的功能恢复
陈有芬, 沈晓震, 叶剑平, 郑艳峰, 朱家骏
金华市人民医院骨一科
摘要:
目的探讨降钙素联合锁定钢板内固定系统治疗老年复杂性胫骨平台骨折的临床疗效。方法2011年1月至2013年12月,将66例就诊的老年骨质疏松性复杂胫骨平台骨折患者随机分为降钙素组与对照组(各33例),两组行锁定钢板内固定术后均常规补充碳酸钙D3片,降钙素组加用鲑鱼降钙素。术后观察骨折愈合、并发症、药物不良反应等情况,检测腰椎部骨密度与膝关节HSS评分。结果术后6个月,除对照组有4例延迟愈合,其余患者均骨折愈合良好。术后1、2年所有患者腰椎骨密度T值较术前均有明显改善(P<0.05),但降钙素组改善程度明显高于对照组(P<0.01);降钙素组术后1、2年的膝关节HSS评分及功能优良率均高于对照组(P<0.05)。随访2年内,降钙素组未发生阻碍治疗的并发症。结论降钙素联合锁定钢板内固定术治疗老年骨质疏松性复杂胫骨平台骨折,有利于促进患者骨折愈合、提高骨密度,改善患肢膝关节功能。
关键词:  鲑鱼降钙素 复杂性胫骨平台骨折 锁定钢板 老年 骨质疏松
DOI:
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基金项目:金华市科技计划项目
Salmon calcitonin enhances recovery of elderly patients with complex tibial plateau fractures treated by locking plate fixation
CHEN Youfen, SHEN Xiaozhen, YE Jianping, ZHENG Yanfeng, ZHU Jiajun
Jinhua People's Hospital
Abstract:
Objective To assess the clinical effect of salmon calcitonin for elderly patients with complex tibial plateau fractures treated by locking plate fixation. Methods Sixty six elderly patients with complex tibial plateau fractures treated by locking plate from January 20110 to December 2013, were randomly divided into calcitonin group and control group (n=33 for each group). After the locking tibial plateau plate internal fixation, all patients were treated with calcium carbonate and vitamin D3 tablets, and the calcitonin group received additional salmon calcitonin. Bone healing, bone mineral density (BMD) and HSS scores were assayed, complications and adverse effects of salmon calcitonin were evaluated. Results There were 4 cases of delayed healing in the control group, but all fractures in the calcitonin group were healed well after 6 months of surgery. In 1 year, 2 years after surgery, the T value of BMD in all patients were significantly increased compared with that pre-surgery (P<0.05). These improvements in the calcitonin group were markedly enhanced compared with the control group (P<0.01). After 1 and 2 years of surgery, the HSS scores and knee joint functions in calcitonin group were significantly increased compared with control group (P<0.05). All patients were followed up at least 2 years, and there was no complication hindering the treatment process in calcitonin group. Conclusion Salmon calcitonin has beneficial effects for treating osteoporotic complex tibial plateau fractures in elderly patients.
Key words:  Salmon calcitonin Complex tibial plateau fracture Locking plate Elderly patients Osteoporosis