Clinical effect of proximal femoral intramedullary nailing in the treatment of intertrochanteric fractures in the elderly and its influence on patients' VAS score / 中国基层医药

ABSTRACT

Objective@#To explore the clinical effect of proximal femoral nailing in the treatment of intertrochanteric fracture of the femur and its effect on patients' VAS score.@*Methods@#From January 2017 to December 2017, 49 elderly patients with intertrochanteric fracture in Hangzhou Dajiangdong Hospital were selected in the research.According to internal fixation methods, the patients were divided into two groups.The PFLP group(25 cases) received proximal femoral locking plate, the PFNA group (24 cases) received proximal femoral intramedullary nail by minimally invasive treatment.The therapeutic effect was compared between the two groups.@*Results@#The operating time, intraoperative blood loss, incision length, the weight bearing time, fracture healing time in the PFNA group were (101.33±39.41)min, (261.08±184.98)mL, (7.66±3.04)cm, (5.58±1.47) weeks, (16.66±2.03) weeks, respectively, which were significantly better than those in the PFLP group [(137.36±43.65)min, (456.40±148.18)mL, (14.76±1.76)cm, (11.4±1.44)weeks, (19.36±3.49)weeks] (t=3.184, 4.085, 10.024, 4.085, 10.024, all P<0.05). At 1, 3, 6 months after operation, the VAS scores of the PFNA group were (6.56±2.87)points, (5.87±1.25)points and (2.62±0.98)points, which were better than those of the PFLP group (t=4.855, 7.545, 8.541, all P<0.05). After treatment, the INF-alpha, IL-6, CRP levels in the PFNA group were (22.39±1.85)ng/L, (120.54±5.24)ng/L, (7.79±2.25)mg/L, respectively, which were significantly lower than those in the PFLP group [(33.69±2.25)ng/L, (154.25±5.52)ng/L, (13.96±3.25)mg/L](t=5.287, 4.987, 5.124, all P<0.05).@*Conclusion@#In the treatment of intertrochanteric fracture, PFNA internal fixation has shorter operation time, less intraoperative blood loss, small incision and minimally invasive fixation, and can get out of bed early after operation, functional exercise can promote fracture healing.It has fewer complications and high clinical value.