髓内钉固定与微创经皮钢板内固定对胫腓骨骨折患者血小板活化及血清转化生长因子-β1和骨形态发生蛋白-2影响的比较
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作者Author单位AddressE-Mail
温成 WEN Cheng 张家口市第二医院老年骨科, 河北 张家口 075000 Department of Elderly Orthopaedics, Zhangjiakou Second Hospital, Zhangjiakou 075000, Hebei, China v06igetahb@21cn.com 
王希杰 WANG Xi-jie 张家口市第二医院老年骨科, 河北 张家口 075000 Department of Elderly Orthopaedics, Zhangjiakou Second Hospital, Zhangjiakou 075000, Hebei, China  
韩俊成 HAN Jun-cheng 张家口市第二医院老年骨科, 河北 张家口 075000 Department of Elderly Orthopaedics, Zhangjiakou Second Hospital, Zhangjiakou 075000, Hebei, China  
王汉伟 WANG Han-wei 张家口市第二医院老年骨科, 河北 张家口 075000 Department of Elderly Orthopaedics, Zhangjiakou Second Hospital, Zhangjiakou 075000, Hebei, China  
期刊信息:《中国骨伤》2023年,第36卷,第11期,第1100-1106页
DOI:10.12200/j.issn.1003-0034.2023.11.018
基金项目:河北医学科学研究课题计划 (编号:20190702)
中文摘要:

目的:探讨髓内钉固定(intramedullary nail fixation,IMN)与微创经皮钢板内固定(minimally invasive percutaneous plate internal fixation,MIPPO)技术应用于胫腓骨骨折的效果及对患者血小板活化及血清转化生长因子-β1(transforming growth factor-β1,TGF-β1)、骨形态发生蛋白-2(bone morphogenetic protein-2,BMP-2)影响。

方法:选取2019年2月至2020年2月胫腓骨骨折患者105例,分为MIPPO组53例和IMN组52例。其中MIPPO组男29例,女24例,年龄(41.74±6.05)岁;IMN组男31例,女21例,年龄(40.59±5.26)岁。比较两组围术期手术指标,术后并发症,术后12个月踝关节功能恢复情况,术前及术后3、7 d血小板活化指标,术前及术后4、8周血清TGF-β1、BMP-2水平。

结果:MIPPO组手术时间、骨折愈合时间短于IMN组(P<0.05);与术前相比,两组术后3、7 d的GMP-140、PAC-1、CD63、CD61水平均提高,但MIPPO组低于IMN组(P<0.05);两组术后4、8周血清TGF-β1、BMP-2水平均较术前提高,且MIPPO组提高幅度大于IMN组(P<0.05);MIPPO组术后并发症发生率低于IMN组(P<0.05)。两组术后随访12个月,踝关节功能Mazur评分比较,差异无统计学意义(P>0.05)。

结论:髓内钉固定与MIPO技术治疗胫腓骨骨折均可改善踝关节功能,但后者具有手术时间短、骨折愈合快、并发症少的优势,且血小板活化轻,血清TGF-β1、BMP-2水平改善快。
【关键词】髓内钉固定  微创经皮钢板内固定  胫腓骨骨折  血小板活化  转化生长因子-β1  骨形态发生蛋白-2
 
Comparative study of the effects of intramedullary nail fixation and minimally invasive percutaneous plate internal fixation technique on platelet activation and serum transforming growth factor-β1(TGF-β) 1 and bone morphogenetic protein-2 (BMP-2) in patients with tibial and fibular fracture
ABSTRACT  

Objective To investigate the effect of intramedullary nail fixation (IMN) and minimally invasive percutaneous plate internal fixation (MIPPO) techniques on tibiofibular fractures and their effect on platelet activation and serum transforming growth factor-β1 (TGF-β1) and bone morphogenetic protein-2 (BMP-2).

Methods Total of 105 patients with tibiofibular fractures from February 2019 to February 2020 were selected and divided into 53 cases in the MIPPO group and 52 cases in the IMN group. There were 29 males and 24 females with an average age of (41.74±6.05) years old in MIPPO group;in IMN group,31 males and 21 females with an average age of (40.59±5.26) years old. The perioperative surgical indexes,postoperative complications,ankle function recovery at 12 months postoperatively,platelet activation indexes at 3 and 7 days preoperatively and postoperatively,and serum TGF-β1 and BMP-2 levels at 4 and 8 weeks preoperatively and postoperatively were compared between the two groups.

Results The operating time and fracture healing time in the MIPPO group were shorter than those in the IMN group(P<0.05); Compared with the preoperative period,the levels of GMP-140,PAC-1,CD63,and CD61 increased in both groups at 3 and 7 days after surgery,but were lower in the MIPPO group than in the IMN group(P<0.05);the levels of serum TGF-β1 and BMP-2 increased in both groups at 4 and 8 weeks after surgery compared with the preoperative period,and the postoperative complication rate in the MIPPO group was lower than that in the IMN group(P<0.05);the difference was not statistically significant in the excellent rate of ankle function recovery at 12 months follow-up after surgery between two groups(P>0.05).

Conclusion Both intramedullary nail fixation and MIPO technique for treatment of tibia and fibula fractures can improve ankle joint function,but the latter has the advantages of short operation time,fast fracture healing,fewer complications,and light platelet activation. Serum TGF-β1,BMP-2 level improves quickly.
KEY WORDS  Intramedullary nail fixation  Minimally invasive percutaneous plate internal fixation  Tibia and fibula fractures  Platelet activation  Transforming growth factor-β1(TGF-β1)  Bone morphogenetic protein-2(BMP-2)
 
引用本文,请按以下格式著录参考文献:
中文格式:温成,王希杰,韩俊成,王汉伟.髓内钉固定与微创经皮钢板内固定对胫腓骨骨折患者血小板活化及血清转化生长因子-β1和骨形态发生蛋白-2影响的比较[J].中国骨伤,2023,36(11):1100~1106
英文格式:WEN Cheng,WANG Xi-jie,HAN Jun-cheng,WANG Han-wei.Comparative study of the effects of intramedullary nail fixation and minimally invasive percutaneous plate internal fixation technique on platelet activation and serum transforming growth factor-β1(TGF-β) 1 and bone morphogenetic protein-2 (BMP-2) in patients with tibial and fibular fracture[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(11):1100~1106
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