中国现代手术学杂志2025，Vol.29Issue(2)：126-134,9.DOI:10.16260/j.cnki.1009-2188.2025.02.007
股骨近端仿生髓内钉内固定治疗老年骨质疏松性股骨颈基底部骨折的临床效果
Clinical efficacy of intramedullary fixation with the proximal femoral bionic nail for elderly osteoporotic basal femoral neck fractures
摘要
Abstract
Objective To evaluate the clinical efficacy of intramedullary fixation with the proximal femoral bionic nail(PFBN)for basal femoral neck fractures in elderly patients with osteoporosis.Methods A retrospective analysis was performed on clinical data from 122 elderly patients with osteoporotic basal femoral neck fractures who underwent surgical treatment in our hospital between April 2022 and May 2023.According to the internal fixation methods,patients were divided into two groups(61 cases each):The observation group received internal fixation with PFBN,while the control group underwent internal fixation with proximal femoral nail antirotation(PFNA).The two groups were compared regarding surgical parameters,fixation stability(maximum load and axial stiffness),rehabilitation progress,complications within 12 months postoperatively,and pre-and postoperative bone metabolism biomarkers,specifically procollagen type Ⅰ N-terminal propeptide(PINP),tartrate-resistant acid phosphatase-5b(TRACP-5b),osteocalcin(BGP),and procollagen type ⅠC-terminal propeptide(PICP),along with functional outcomes assessed by Harris Hip Scores and Activities of Daily Living(ADL)scores.Results Compared to the control group,maximum load and axial stiffness were significantly higher,and time to partial weight-bearing,full weight-bearing,and fracture healing were all shor-ter in the observation group(P＜0.001).All patients were regularly followed up for 12 months postoperatively.At 2 and 4 weeks postoperatively,compared to preoperative levels,serum PINP,BGP,and PICP levels increased significantly,while TRACP-5b levels decreased significantly in both groups(all P＜0.05).Furthermore,serum levels of PINP,BGP,and PICP were significantly higher,whereas TRACP-5b levels were significantly lower in the observation group than those in the control group(all P＜0.05).At both 6 and 12 months postopera-tively,Harris Hip Scores and ADL scores were significantly higher in the observation group than those in the control group(both P＜0.05).Postoperative complication rates showed no statistically significant difference between the observation group and the control group(3.28％vs.11.48％,P＞0.05).Conclusions PFBN fixation demonstrates superior clinical efficacy in the treatment of osteoporotic basal femoral neck fractures in elderly patients.The system significantly enhances fixation stability,restores bone formation-resorption equilib-rium,accelerates fracture healing,enables earlier postoperative weight-bearing,and effectively improves hip function and activities of daily living.关键词
股骨颈基底部骨折/骨质疏松/骨折固定术,内/股骨近端仿生髓内钉/股骨近端防旋髓内钉/老年人Key words
femoral neck basal fractures/osteoporosis/fracture fixation,internal/proximal femoral bionic nail/proximal femoral nail antirotation/aged引用本文复制引用
王臣,田彪,徐贺轩,赵吉堂..股骨近端仿生髓内钉内固定治疗老年骨质疏松性股骨颈基底部骨折的临床效果[J].中国现代手术学杂志,2025,29(2):126-134,9.基金项目
河北省医学科学研究课题(20241451) （20241451）
