| Research purposes:1,to explore the elderly femoral intertrochanteric fracture Allen phosphonic acid sodium and simvastatin combined influence on fracture healing,2,from the bone formation and inhibit bone absorption two aspects can observe and study simvastatin alone or with double phosphonic acid salts drugs produce synergistic effect,for the elderly femoral intertrochanteric fracture resistance to provide basis for osteoporosis treatment.Selection methods:our hospital orthopedic in March 2016-March 2017,more than 60,102 patients with intertrochanteric fractures as the research object,were performed open reduction and internal fixation of intertrochanteric fractures,preoperative all check dual-energy X-ray absorptiometry(specific diagnosis of osteoporosis,all patients were performed postoperative alpha D3,calcium tablet for standard care.Among them,36 patients with dysplasia were set as group a(treatment group 1),and simvastatin + alendronate sodium was given after the operation.The other 66 patients were divided into two groups using the digital table randomization method,and the group b(treatment group 2)was treated with alendronate sodium.In the group c(blank group),31 patients received only the standard treatment of alpha-D3 and calcium tablets,and there was no statistically significant difference between the three groups of gender,fracture limb,average age and fracture classification(P BBB 0 0.05).At 1 week,1 month,3 months and 6 months after surgery,the patients in the outpatient department reviewed the X-ray film of the right side of the hip joint to evaluate the bone healing.Preoperative,3 months,6 months and 12 months were used to measure bone density by Expert--XL double-energy X-ray bone density instrument.Serum osteocalcin(BGP)and serum bone specific alkaline phosphatase(BAP)were detected within 1 week,6 weeks,3 months and 6 months after surgery.Results:1)there was no statistically significant difference in fracture healing scores between the three groups after 1 week and 1 month after surgery(P>0.05).After 3 months and 6 months after surgery,the score of fracture healing in group a was significantly higher than that in group b and c,and the score of fracture healing in group c was significantly higher than that in group b,all of which had statistical significance(P< 0.05).2)changes in bone density: there was no statistical significance(P>0.05)in the three groups before operation.In the three months after surgery,the T value of bone density in the three groups was significantly higher than that in the six months and 12 months,and the difference was statistically significant(P < 0.05).Group,according to two comparison between 6 months and 12 months postoperatively,bone mineral density T value higher than group b,group a,group c bone mineral density T value higher than group b,group c difference had statistical significance(P < 0.05).3)bone metabolism index: before operation,there was no significant difference between BGP and BAP level within 1 week after surgery(P>0.05).In 6 weeks and 3 months after surgery,the level of BGP and BAP in group a and group b was significantly higher than that in the preoperative period,and the differences were statistically significant(P < 0.05).In group c,the level of BAP was significantly higher in 6 weeks and 3 months after surgery than before operation,and the difference was statistically significant(P < 0.05).There was no significant difference in BGP level between 6 weeks and 3 months after surgery in group c(P>0.05).Compared between two groups,after 6 weeks,3 months,6 months in group a of BGP,BAP levels higher than group b,group c,group b BGP,BAP levels higher than that of group c,differences were statistically significant(P < 0.05).4)after 1 month of the hip is oblique X-ray examination,according to the results of each group of intertrochanteric fracture line are more apparent,periosteum hyperplasia is not obvious,uneven fracture gap is a little sparse callus formation and fracture zone are low density,no difference between the groups of patients.Three months after the operation,all patients had bone healing,and the fracture zone density of clam a was slightly higher than group b and group c.The density of fracture area in group c was slightly higher than that in group b,and group b was larger than group a and group c.6 months after the operation,the fracture line of group a and c was unclear,and the fracture line in group c was vague,but the fracture line still existed.Conclusion:1)the single use of alendronate and combined with simvastatin can increase the bone density and prevent osteoporosis,but the combined effect is better than the single use alone.2)alendronate sodium phosphonic acid can inhibit bone chi form the role of the elderly femoral intertrochanteric fracture use Allen’s phosphonic acid sodium can delay fracture healing,and simvastatin combination has a role in fracture healing,that Allen phosphonic acid sodium and simvastatin combined with synergy.3)the single use of alendronate and combined with simvastatin can increase the level of BGP and BAP,but the combined effect is better than the single use. |
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