Abstract：Objective: To investigate the effect of closed reduction and anti rotation intramedullary nail (PFNA) internal fixation in the treatment of osteoporotic femoral trochanteric fracture in the elderly. Methods: 98 cases of senile osteoporotic fracture of femoral trochanter were divided into PFEN group (n=50) and control group (n=48), PFNA group closed reduction PFNA internal fixation treatment, the control group was given dynamic hip screw treatment. Comparing the excellent and good rate of the two groups after treatment, recording the related indicators of the patients, comparing the Lane-Sandhu X-ray callus growth score, ADL score changes and the quality of life score changes before and after surgery, comparing the incidence of complications. Results: The operation time, fracture healing time and hospitalization time of PFNA group were shorter than those of control group (P<0.05). The bleeding volume and hip function score of PFNA group were lower than those of control group (P<0.05), and the excellent and good rate of PFNA group was higher than that of control group (94.00% vs 70.83% P<0.05). The Lane-Sandhu X-ray callus growth score and ADL score of PFNA group were higher than those of control group at 8 and 12 weeks after operation (P<0.05), and the quality of life score of PFNA group was higher than that of control group (P<0.05). During the treatment, complications such as internal fixation breakage, delayed union, malunion, wound infection and wound swelling occurred in both groups. The total incidence of PFNA group was lower than that of control group (10.00% vs 29.17% P<0.05). Conclusion: Closed reduction and PFNA treatment for elderly patients with osteoporotic femoral trochanteric fracture can promote fracture healing, improve hip function and shorten hospitalization time. And the incidence of complications is low; the safety is high; the quality of life of patients is effectively improved; and the curative effect is remarkable.
[1] 符前仁,杜宁,龙鹏,等.PFNA、LISS治疗老年骨质疏松性股骨粗隆间骨折效果比较[J].山东医药,2016,56(46):94~96. [2] Yang X, Wu Q, Wang X. Investigation of perioperative hidden blood loss of unstable intertrochanteric fracture in the elderly treated with different intramedullary fixations[J]. Injury-international Journal of the Care of the Injured, 2017, 48(8):1848~1892. [3] Pan S, Liu X H, Feng T, et al. Influence of different great trochanteric entry points on the outcome of intertrochanteric fractures: a retrospective cohort study[J]. Bmc Musculoskeletal Disorders, 2017, 18(1):107~110. [4] Fernandez D L, Capo J T, Gonzalezhernandez E, et al. Nonunion of greater trochanter following total hip arthroplasty: Treated by an articulated hook plate and bone grafting[J]. Indian Journal of Orthopaedics, 2017, 51(3):273~279. [5] Shen J, Leslie W D, Nielson C M, et al. Associations of Body Mass Index With Incident Fractures and Hip Structural Parameters in a Large Canadian Cohort[J]. Journal of Clinical Endocrinology & Metabolism, 2016, 101(2):476~479. [6] 高飞,周武,谢卯,等.PFNA联合规范化抗骨质疏松药物治疗老年骨质疏松性股骨转子间骨折[J].第二军医大学学报,2017,38(4):437~442. [7] Zeng X, Zhang N, Zeng D, et al. Proximal femoral nail antirotation versus dynamic hip screw fixation for treatment of osteoporotic type 31-A1 intertrochanteric femoral fractures in elderly patients[J]. Journal of International Medical Research, 2017, 45(3):1109~1123. [8] Caruso G, Bonomo M, Valpiani G, et al. A six-year retrospective analysis of cut-out risk predictors in cephalomedullary nailing for pertrochanteric fractures: Can the tip-apex distance (TAD) still be considered the best parameter[J]. Bone & Joint Research, 2017, 6(8):481~485. [9] Xie H, Wang Z, Zhang J, et al. Clinical outcome of dynamic hip locking plates and proximal femoral nails anti-rotation-Asia for treating intertrochanteric femur fracture with lateral wall fractures in the elder patients[J]. Oncotarget, 2017, 8(47):82700~82704.
2019, Vol. 25 
冀公网安备13080202000677号