Effect of parallel double locking plate fixation on the indexes of trauma and bone metabolism in patients with distal humerus type C fracture
10.3760/cma.j.cn115396-20200616-00199
- VernacularTitle:平行双锁定钢板固定术对肱骨远端C型骨折患者术后创伤指标和骨代谢指标的影响
- Author:
Hong ZHANG
1
;
Duo LU
;
Qin WANG
Author Information
1. 内蒙古包钢医院骨科，包头 014010
- From:
International Journal of Surgery
2020;47(7):470-475
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of parallel double locking plate fixation on the postoperative trauma and bone metabolism in patients with distal humerus type C fracture.Methods:Retrospective analysis of clinical data of 75 patients with type C fracture of distal humerus admitted to the department of orthopedics, Baogang Hospital, Inner Mongolia from January 2017 to January 2019 was conducted. There were 46 males and 29 females, aged (45.14 ± 10.36) years and ranging from 22 to 69 years. According to the internal fixation method, they were divided into the control group ( n=36) and the observation group ( n=39). The control group was treated with Y-plate internal fixation, and the observation group was treated with parallel double locking plate fixation, which was compared with the operation time, intraoperative bleeding, fracture healing time and the excellent and good rate of elbow joint function of the two groups. The levels of LDH, ckeatine kinase, GPT, GOT, C3 and C4 were compared between the two groups. The bone metabolism indexes of the two groups were Osteocalcin, BALP, PINP, CTX and TRAP. The level of PYD and complications of the two groups were compared. The measurement data were expressed as mean±standard deviation ( Mean± SD), the t test was used for comparison between groups, and the count data were expressed as percentage (%), the chi-square test was used for comparison between groups. Results:There was no significant difference in operative time and intraoperative hemorrhage between the two groups ( P>0.05). The fracture healing time of the observation group was (10.22±2.16) weeks, shorter than that of the control group (13.63 ± 2.39) weeks, with a statistically significant difference ( P<0.05), the excellent and good rate of elbow joint function of the observation group was 82.05%(32/39), higher than that of the control group (61.11%, 22/36), with a statistically significant difference ( P<0.05). The levels of LDH, creatine kinase, GPT, GOT in the observation group were (205.36±20.51) U/L, (25.19±3.97) U/L, (11.37±2.04) U/L, (9.35±1.02) U/L, respectively, which were lower than those in the control group [(248.95±22.73) U/L, (41.85±4.64) U/L, (18.76±2.12) U/L, (16.68±1.34) U/L], complement C3 and C4 were (1.48 ± 0.16) g/L, (0.45 ± 0.07) g/L, which were higher than those of the control group [(1.15±0.14) g/L, (0.23±0.06) g/L], the difference was statistically significant ( P<0.05). Osteocalcin, BALP and PINP in the observation group were (6.27 ± 0.92) μg/L, (71.05 ± 7.46) IU/L, (92.39 ± 7.12) ng/mL, respectively, which were higher than those in the control group [(5.63 ± 0.76) μg/L, (64.82 ± 6.88) IU/L, (79.47 ± 8.64) ng/mL]. The levels of CTX, TRAP and PYD in the observation group were (5.52 ± 0.96) ng/mL, (3.47 ± 0.61) U/L, (25.07 ± 4.02) U/L, respectively, which were lower than those in the control group [(6.38 ± 0.99) ng/mL, (4.40 ± 0.73) U/L, (29.14 ± 3.85) U/L], with a statistically significant difference ( P<0.05), the incidence of postoperative complications in the observation group was 10.26% (4/39), lower than 30.56% (11/36) in the control group, with a statistically significant difference ( P<0.05). Conclusions:The treatment of C-type fracture of distal humerus with parallel double locking plate can improve the elbow joint function. The postoperative trauma is lighter, the bone metabolism is better, and it has more advantages than Y-type plate internal fixation, which is worth popularizing.
