Effect of Different Treatment Methods on Hip Joint Function and Related Cytokines in Displaced Femoral Neck Fracture
ZHONG Jie-lin,CAI Ying,JIN Cheng-hao
Fourth Orthopaedics Departments, Tianjin Teda Hospital, Tianjin (300475), China
Abstract:
Objective To investigate the effects of total hip replacement and dynamic hip screw internal fixation on hip function, serum inflammatory factors and biochemical indicators of delayed union of displaced femoral neck fracture. Methods The clinical data of 100 patients with displaced femoral neck fracture treated in our hospital from July 2014 to July 2016 were retrospectively analyzed. Fifty-two patients undergoing total hip arthroplasty were treated as observation group and 48 patients undergoing hip screw internal fixation were treated as control group. The Aubignbey-Postel score and complications of hip joint function improvement before and 12 months after treatment were compared and analyzed between the two groups. Serum inflammatory factors such as interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β), insulin-like growth factor-1 (IGF-1), soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (Svcam-1) and type I collagen carboxyl terminal peptide beta special sequence (β-CTX) were measured before and 1 week after operation. Results After 12 months of surgery, the improved hip function Aubigné-Postel score of the observation group was 82.96%, which was significantly higher than that in the control group (62.50%) for the same period, and the difference was statistically significant (P<0.05); Twelve months after the operation, the incidence of complications in the observation group was 1.92% (1 case), significantly lower than that in the control group (29.17%, 14 cases), and the difference was statistically significant (P < 0.05). Before treatment, the levels of IL-6, TNF-α and IL-1β in the observation group were (9.8±1.1) pg/mL, (2.3 0.4) ng/mL and (2.9±0.3) pg/mL respectively, while those in the control group were (9.9±1.2) pg/mL, (2.2±0.4) ng/mL and (2.8±0.3) pg/mL respectively, with no significant difference (P>0.05). One week after treatment, the levels of IL-6, TNF-α and IL-1β in the two groups increased significantly, which were (11.1±1.3) pg/mL, (3.2±0.4) ng/mL, (3.2±0.4) pg/mL in the observation group, and (15.2±1.5) pg/mL, (5.5±0.5) ng/mL and (5.7±0.6) pg/mL in the control group, respectively, and the difference between two groups was statistically significant (P<0.05). Before treatment, the serum insulin-like growth factor-1 (IGF-1), serum soluble vascular cell adhesion molecule-1 (Svcam-1) and type I collagen carboxy-terminal peptide β special sequence (β-CTX) in the observation group were (207.2±44.1) ng/mL, (913.2±55.2) ng/mL, and (458.6±32.5) pg/mL, respectively, and those in the control group were (205.9±43.7) ng/mL, (908.6±54.7) ng/mL, and (461.3±29.7) pg/mL, respectively, with no significant difference (P> 0.05). After 12 weeks of treatment, IGF-1, Svcam-1 and β-CTX in the observation group were (338.1±53.3) ng/mL, (611.3±44.6) ng/mL, and (498.1±30.5) ng/mL, respectively, while those in the control group were (411.6±65.8) ng/mL, (319.1±31.5) ng/mL, and (526.4±41.3) pg/mL, respectively. The levels of IGF-1 and β-CTX in the two groups were significantly higher than those before treatment, and the level of Svcam-1 was significantly lower. The change range of the observation group was significantly better than that of the control group, and the difference was statistically significant (P<0.05). Conclusion Total hip arthroplasty has a small inflammatory response to displaced femoral diameter fractures, which can significantly reduce postoperative complications and has a good long-term effect.
