Evaluation of internal fixation with proximal femoral nail antirotation in elderly knee osteoarthritis patients with femoral intertrochanteric fractures / 中国组织工程研究

ABSTRACT

BACKGROUND: Proximal femoral nail antirotation is a commonly used internal fixation system for the treatment of femoral intertrochanteric fracture in the elderly. Simultaneously, the elderly are often associated with knee osteoarthritis, which may affect the postoperative effect of femoral intertrochanteric fracture. OBJECTIVE: To investigate the effect of knee osteoarthritis at the fracture side on the efficacy of postopenxtine proximal femoral nail antirotation in elderly femoral intertrochanteric fractures. METHODS: Totally 92 patients aged over 65 years old with femoral intertrochanteric fractures treated with proximal femoral nail antirotation internal fixation were divided into five groups according to the preoperative knee X-ray Kellgren-Lawrence grade grade 0 as group A (13 cases), grade I as group B (18 cases), grade II as group C (23 cases), grade III as group D (22 cases), and grade IV as group E (16 cases). The hospitalization time, postoperative complications, postoperative landing time, fracture healing time, hip Harris score and Barthel index score of daily living ability at 1, 3 and 6 months after operation were recorded in the five groups. This study was approved by the Ethics Committee of Affiliated Hospital of Chengde Medical University. RESULTS AND CONCLUSION: (1) There was no significant difference in the length of hospital stay among the five groups (P > 0.05). (2) The postoperative landing time and fracture healing time of group D and group C were longer than those in group A, group B, and group C (P < 0.05). (3) The number of postoperative complications of group C was more than those in group A and group B (P < 0.05). The number of postoperative complications of group D and group E was more than that in group A, group B and group C (P < 0.05). (4) The scores of Harris and Barthel index of group C and D were lower than those in group A and B at 1, 3 and 6 months after operation (P < 0.05). The scores of Harris and Barthel index of group E was lower than those in group A, group B, group C and group D at 1, 3 and 6 months after operation (P < 0.05). (5) The results showed that the higher the grade of knee osteoarthritis, the greater the influence on the postoperative efficacy of proximal femoral nail antirotation in the treatment of elderly patients with femoral intertrochanteric fracture. It is manifested by increased postoperative complications, prolonged postoperative landing time and fracture healing time, and the decrease of hip function and ability of daily living.