| Objective:To evaluate the clinical efficacy of internal fixation combined with anti-osteoporosis drugs in the treatment of proximal humeral fractures.Methods:1 Case collection: From November 2015 to November 2017,the hospital of Chengde Medical College was selected to perform open reduction and internal fixation of locked proximal humerus plate and is willing to cooperate with the investigation.68 patients with complete follow-up investigation data were selected as the study object,among which There were 23 males and 45 females;aged between 58 and 83 years old,with an average of 70.3±7.0 years;Neer type,26 cases of two part fractures,and 42 cases of three part fractures.2 Grouping method: Patients were divided into basic treatment group(35 cases)and combination therapy group(33 cases)according to whether the patient received combined anti-osteoporosis treatment.The basic treatment group was applied to the internal fixation of locking plate after the application of Calcium D,calcitriol,and the combined treatment group based on basic treatment plus salmon calcitonin combined anti-osteoporosis treatment.3 Observation indexes: Pain degree was assessed by Visual Analogue Pain Scale(VAS)on the first day,1 week,2 weeks,3 weeks,4 weeks after operation after operation;X-rays were observed at 4 weeks,8 weeks,12 weeks,and 48 weeks after surgery.The patient’s fracture healing and dual-energy X-ray absorptiometry(DXA)were used to measure the proximal tibial bone mineral density(BMD).Neer shoulder functional score was used to evaluate the function of ipsilateral shoulder function at 48 weeks after operation.The incidence of postoperative complications in the group of patients.4 Statistical methods: SPSS22.0 software was used for data analysis,and P<0.05 was considered statistically significant.The results of measurement data were expressed as x ±s.The χ2 test was used to compare the two groups of count data,and the measurement data were compared using t test or analysis of variance.Results:The VAS scores of the combined treatment group on the first day,1 week,2 weeks,3 weeks,4 weeks postoperatively were 8.7±0.7,4.5±0.9,3.1±0.5,2.2±0.6,1.0±0.7,respectively.For 8.6±1.0,6.7±0.8,5.1±0.6,4.1±0.9,3.1±0.6,repeated-measures analysis of variance showed that the comparison between the two groups was: F=176.347,P<0.001,indicating that the two groups differed in VAS scores.has statistical significane;in fracture healing time,the mean duration of the combined treatment group was 13.3±0.4 weeks,and the average of the basic treatment group was 16.2±0.7 weeks,with a statistically significant difference(P<0.05);the results of preoperative bone mineral density measurement showed that there was no significant difference between the two groups(P>0.05),bone mineral density was increased in both groups after treatment,but the combined treatment group increased more significantly(P<0.05).In addition,the results of this study showed that the difference in bone mineral density between the two groups at 8 weeks after surgery began to have statistical significance(P<0.05);at 48 weeks postoperatively,shoulder function scores showed that the excellent rate of Neer score in the combined treatment group was 90.9%.The excellent rate of basic treatment group was 77.1%,and the difference was statistically significant(P<0.05);follow-up observation of the incidence of complications in the two groups of patients,the results found that the basic treatment group showed loosening of the steel plate in 1 case,fibula head necrosis in 1 case,the joint treatment group showed loosening of the steel plate in 1 case,the difference was not statistically significant(P<0.05).Conclusion:Locking steel plate after the treatment of proximal humerus fractures with salmon calcitonin combined with anti-osteoporosis treatment effect is significantly better than conventional anti-osteoporotic drugs,it can relieve pain in patients with short-term,shorten fracture healing time,increase bone density,and then better restore shoulder function. |
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