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| Prognostic value of serum osteosin combined with procollagen typeⅠN-terminal propeptide in predicting hip dysfunction in elderly patients with intertrochanteric fracture of femur after proximal femoral nail antirotation |
| ZHAI Jiangbo1 HENG Dezhong1▲ YAO Peng2 |
1.Department of Orthopedics, Yellow River Sanmenxia Hospital, Henan Province, Sanmenxia 472000, China;
2.Clinical Laboratory, Yellow River Sanmenxia Hospital, Henan Province, Sanmenxia 472000, China
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Abstract Objective To investigate the prognostic value of serum osteosin (OSTN) combined with procollagen typeⅠN-terminal propeptide (PⅠNP) in predicting hip dysfunction after proximal femoral nail antirotation (PFNA) in elderly pa- tients with intertrochanteric fracture of femur (IFF). Methods A total of 200 elderly IFF patients who underwent PFNA surgery in the Department of Orthopedics of Yellow River Sanmenxia Hospital, Henan Province from February 2019 to December 2021 were selected and divided into adverse group (51 cases) and excellent group (149 cases) according to the Harris hip function score at one year after surgery. The clinical data and serum OSTN, PⅠNP levels were compared between the two groups, and the influencing factors of hip dysfunction in elderly IFF patients after PFNA surgery were analyzed. The predictive value of serum OSTN and PⅠNP levels in elderly IFF patients after PFNA surgery was analyzed by receiver operating characteristics (ROC) curve. Results Age, proportion of complications before surgery, proportion of American Society of Anesthesiologists rating ≥Ⅲ before surgery, proportion of Evans-Jensen classification ≥Ⅲ before surgery, proportion of severe osteoporosis, and serum OSTN, PⅠNP levels in the adverse group were higher than those in the excellent group, and the differences were statistically significant (P＜0.05). The results of multivariate analysis showed that age, preoperative comorbidities, American Society of Anesthesiologists rating before surgery, Evans-Jensen classification before surgery, osteoporosis, and serum OSTN, PⅠNP levels were independent influencing factors for hip dysfunction in elderly IFF patients after PFNA surgery (P＜0.05). ROC curve analysis results showed that the area under the curve of the combined prediction of serum OSTN and PⅠNP levels of hip dysfunction in elderly IFF patients after PFNA was larger than that of the two alone (P＜0.05). Conclusion The elevated serum OSTN and PⅠNP levels in elderly IFF patients are associated with hip dysfunction after PFNA surgery, and may be auxiliary predictors of IFF.
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