Comparision of Clinical Effects of Intramedullary Nail with Lock and Plate Screw Fixation in Patients with Bone Nonunion After Limb Trauma Fracture of Extremities
RU Qingchao
YANG Ting
ZHANG Zhichang
LU Tan
Abstract：Objective To compare the efficacy of intramedullary nail with lock(INWL)and plate screw fixation in the treatment of nonunion after limb trauma fracture(NALTF).Methods The data of 76 patients with NALTF(from May 2022 to October 2023)in the First Affiliated Hospital of Xinxiang Medical University were retrospectively collected and divided into two groups according to surgical protocols.Thirty-eight patients received INWL fixation were included as observation group,and 38 patients received plate screw fixation were included as control group.The surgical outcome,surgical indicators,visual analogue scale(VAS),Constant-Murley shoulder function assessment scale(CMS),American hospital for special surgery knee joint score(HSS),serum associated cytokines[β-collagen degradation products(β-CTX),osteoprotegerin(OPG),bone morphogenetic protein-2(BMP-2)]levels and complication rate were compared between the two groups.Results Compared with the control group,the excellent and good rate of operation was 78.95％(30/38),and the observation group[97.37％(37/38)]was higher(P＜0.05).Compared with the control group,the observation group had lower intraoperative blood loss,shorter fracture healing,operation and hospitalization time(P＜0.05).Compared with before surgery,3 months after surgery,VAS score of the two groups decreased,CMS and HSS scores increased,and VAS score of the observation group was lower than that of the control group,CMS and HSS scores were higher than those of the control group(P＜0.05).Compared with pre-operation,serum β-CTX level decreased and OPG and BMP-2 levels increased in both groups 3 months after operation.serum β-CTX level in the observation group was lower than that in the control group,while serum OPG and BMP-2 levels were higher than those in control group(P＜0.05).Compared with the control group,the complication rate was 23.68％(9/38),and the observation group[2.63％(1/38)]was lower(P＜0.05).Conclusion Compared with plate screw internal fixation in NALTF patients,INWL fixation can further improve the surgical effect,optimize the surgical indicators,reduce pain,improve the shoulder and knee functions,reduce complications,improve the level of serum related cytokines,and promote fracture healing.
Keywords：nonunion after limb trauma fractureintramedullary nail with lockserum related cytokinesjoint functionfracture healing time
Publication Date：2024-10-31
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：4( 3688-3691 )