| Objective:To explore the postoperative function and prognosis of elderly patients with osteoporotic intertrochanteric fracture treated with calcitonin,in order to clarify the efficacy of calcitonin in elderly patients with osteoporotic fracture after surgery,and to provide certain clinical basis for better guidance and standard clinical treatment of osteoporotic fracture.Methods:Atotal of 132 elderly patients with intertrochanteric fracture of femur in the inpatient department of trauma surgery of our hospital from September 2020 to December 2021 were retrospectively selected.According to the inclusion and exclusion criteria,120 patients met the criteria.Regular outpatient and telephone follow-up were conducted for all patients after surgery.The patients were randomly divided into experimental group,control group and blank group according to the different postoperative treatment methods.There were 36 cases in the blank group,43 cases in the control group and 41 cases in the experimental group.The patients in the blank group did not take anti-osteoporosis drug treatment after the operation,but only used the postoperative conventional treatment,and the control group was supplemented with calcium and vitamin D after the operation.The experimental group was additionally given ecalcitonin on the basis of the control group.All patients were followed up for 12 months.The bone mineral density,bone metabolism indexes,hip joint function,postoperative pain,refracture rate,alkaline phosphatase content,fracture healing time and other indexes of the three groups were compared at different time points before and after surgery by outpatient field and telephone follow-up.To analyze the efficacy and prognosis of ecalcitonin in the treatment of elderly patients with PFNA after operation.Results:During the follow-up,9 cases were terminated due to the death of patients,and 111 cases were finally obtained complete follow-up data.In the control group,3patients died within 1 year after surgery,1 died due to complications of hip fracture and 2 died due to old age.In the experimental group,2 patients died within 1 year after surgery,1 patient died due to underlying diseases and 1 patient died at old age.In the blank group,4 patients died,2 died due to surgical complications,1 died due to old age,and 1 died due to underlying diseases.A total of 111 patients were followed up.Harris hip pain score,pain VAS score,bone mineral density,bone metabolism,refracture rate and alkaline phosphatase content were analyzed.Statistical results showed that the Harris scores of the three groups were statistically different from those of the experimental group,the blank group and the control group one year after surgery,indicating that the application of ecalcitonin anti-osteonasone therapy can effectively improve the postoperative hip function of patients.One year after surgery,VAS score of the three groups was significantly higher in the experimental group than in the other two groups,indicating that the use of calcitonin in the treatment process can effectively relieve pain.One year after surgery,the bone mineral density of the three groups was higher in the experimental group than in the other two groups,with statistical significance,indicating that the use of calcitonin anti-bone pine therapy could improve the bone mineral density of patients,while the combined use of vitamin D and calcium could not significantly improve bone mineral density.β-CTX was lower in the experimental group than in the other two groups 1 year after surgery,indicating that the application of calcitonin anti-osteoblast therapy can reduce the activity of osteoclasts and thus inhibit their function,while the use of vitamin D and calcium could not significantly reduce β-CTX index.Comparison of alkaline phosphatase indexes among the three groups 1 year after surgery showed no statistical difference between the three groups.The T value of bone mineral density 1 year after operation was compared among the three groups,and there was statistical difference.In the blank group,a total of 32 patients were followed up one year after surgery.A total of 5 patients had refractures,including 3 lumbar compression fractures,1 hip fracture,and 1 distal radius fracture,with a refracture rate of 15.6%.In the control group,40 patients were followed up 1 year after surgery.A total of 6patients developed refractures,including 2 lumbar compression fractures,2 distal radius fractures,and 2 hip fractures.The incidence of refracture was about 15.0%.In the experimental group,39 patients were followed up 1 year after surgery,among which 1 case of proximal humerus fracture was found,the rate of refracture was2.6%.There was no significant difference in the incidence of refracture among the three groups within 1 year after surgery(P=0.11>0.05).Harris score: There was no significant difference in Harris score between the three groups before surgery and 6 months after surgery(P >0.05).1 year after surgery,the Harris score of the experimental group was higher than that of the other two groups,P <0.05,showing a statistical difference.Harris score showed a gradually increasing trend before surgery,6 months after surgery and 1 year after surgery,and the pairwise comparison of time nodes showed P<0.05,which was statistically significant.VAS score: There was no significant difference in VAS score between the three groups before surgery and 1 day after surgery(P>0.05).The VAS score of the three groups decreased gradually from preoperative,1 day and 12 months after surgery.Compared with the VAS score of the three groups at 12 months after surgery,the score of the experimental group was higher than that of the other two groups,P <0.05,showing a statistical difference.Bone mineral density: After comparison of bone mineral density before surgery,P value was >0.05,which had no statistical significance.There was no significant difference in bone mineral density between the blank group and the control group at 6months and 1 year after surgery,and P>0.05 was not statistically significant.The bone mineral density of the experimental group before surgery and 1 year after surgery and6 months after surgery and 1 year after surgery were significantly different.The bone mineral density of the patients at 1 year after surgery was significantly increased compared with the bone mineral density before surgery and 6 months after surgery,and P<0.05 was statistically significant.There was no significant difference in bone mineral density between preoperative and postoperative 6 months(P>0.05).Bone metabolism: There was no statistical difference between the three groups in preoperative bone metabolism comparison,P>0.05.The β-CTX of the experimental group at 6 months and 12 months after surgery was significantly lower than that before surgery,P <0.05,there was a significant statistical difference;The β-CTX of the experimental group at 12 months after surgery and 6 months after surgery was compared,P<0.05,with statistical difference,while the β-CTX of the control group and the blank group before surgery,6 months after surgery,12 months after surgery had no significant difference,P >0.05,with no statistical difference.Alkaline phosphatase: There was no statistical difference in the level of alkaline phosphatase between the two groups before and after surgery(P>0.05),and there was no statistical difference in the level of alkaline phosphatase between the three groups and within the three groups before and after surgery(P>0.05).Fracture healing time: Compared with postoperative fracture healing time of the three groups,the healing time of the experimental group was shorter than that of the other two groups(P<0.05),with statistical difference.Conclusion:Osteoporosis seriously affects the prognosis of elderly patients with hip fracture.PFNA surgery has the advantages of less trauma,quick recovery and less bleeding.Anti-osteoporosis drugs such as calcitonin have significant clinical benefits in improving bone mineral density,regulating bone turnover indicators,and further reducing pain.Focusing on anti-bone pine therapy for postoperative patients with osteoporotic intertrochanteric fracture of femur is conducive to functional recovery of patients and improve clinical prognosis,and satisfactory clinical effects can be obtained. |
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