Impact of the Reimplantation of Medullary Expanders on Bone Healing During Closed Reduction and Intramedullary Nail Fixation for Femoral Fractures
LU Quanxiu
LU Ming
HE Zeyang
HOU Xizhi
JIN Jie
FU Qiang
Abstract：Objective To explore the value of reimplantation of medullary expanders in the treatment of patients with femoral fractures through closed reduction and intramedullary nail fixation.Methods A total of 62 patients with fem-oral fractures admitted from February 2022 to February 2024 were selected and randomly divided into the observation group(n=31)and the control group(n=31)by the random number table method.Among them,the observation group underwent re-implantation of medullary expanders during intramedullary nail fixation,while the control group underwent intramedullary nail fixation.The perioperative indicators,fracture healing indicators,serum bone metabolism indicators[bone alkaline phospha-tase(BALP),osteocalcin,procollagen typeⅠN-terminal propeptide(PⅠNP)],bone mineral density at the fracture end[change value of bone mineral density at the fracture end(ROI 1),change value of bone mineral density at the proximal fracture end(ROI 2),change value of bone mineral density at the distal fracture end(ROI 3)],lower extremity function score and complications were compared between the two groups.Results There was no significant difference in the perioperative indicators between the two groups(P>0.05).The callus formation,fracture healing and complete weight-bearing time in the observation group were shorter than those in the control group(P<0.05).At 2 and 4 weeks after operation,the levels of serum BALP,osteocalcin and PⅠNP in the observation group were higher than those in the control group(P<0.05).At 3 months after operation,one patient in the observation group was lost to follow-up and two patients in the control group were lost to follow-up.At 1 and 3 months after operation,the ROI 1,ROI 2,ROI 3 and lower extremity function score of the observation group were higher than those of the control group(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion During closed reduction and intramedullary nail fixation of femoral fractures,the reimplanta-tion of medullary expanders can improve bone metabolism,enhance bone mineral density at the fracture site,promote fracture healing,improve lower extremity function,and will not increase the risk of complications.
Keywords：Femoral fracturesClosed reductionIntramedullary nailInternal fixationMedullary expandersBone healingBone metabolism
Publication Date：2025-06-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 63-67 )