Clinical efficacy of two different internal fixations in treating femoral intertrochanteric fractures in older adult patients / 中国基层医药

ABSTRACT

Objective:To investigate the clinical efficacy of two different internal fixations in the treatment of femoral intertrochanteric fractures in older adult patients.Methods:The clinical data of 152 older adult patients with femoral intertrochanteric fractures who were treated at the Second People's Hospital of Hefei from January 2019 to December 2022 were retrospectively analyzed. All patients underwent closed reduction and internal fixation surgery. They were divided into two groups based on the different types of internal fixations used. Among them, 76 patients received internal fixation using proximal femoral intramedullary nails (group A), while 76 patients received internal fixation using Intertan nails (group B). The intraoperative blood loss volume, surgical time, postoperative complications, fracture healing time, and hip joint function score were compared between the two groups.Results:The intraoperative blood loss volume in group A was (197.11 ± 37.85) mL, which was significantly less than that in group B [(226.84 ± 54.17) mL, t = 1.62, P < 0.001]. Surgical time in group A was (71.16 ± 15.64) minutes, which was significantly shorter than that in group B [(78.49 ± 15.88) minutes, t = 1.67, P < 0.001]. The fracture healing time in group A was (13.29 ± 0.94) weeks, which was not significantly different from that in group B [(13.20 ± 0.64) weeks, t = 0.33, P > 0.05]. However, the incidence of postoperative complications in group A was 5.26% (4/76), which was significantly higher than 1.32% (1/76) in group B ( χ2 = 4.04, P = 0.048). At 1 and 3 months and 1 year after surgery, the hip joint function score in group A was (63.13 ± 2.41) points, (73.50 ± 3.99) points, and (84.13 ± 7.57) points, respectively, and it was (68.65 ± 2.65) points, (79.07 ± 3.38) points, and (89.56 ± 7.71) points, respectively, in group B. At the above-mentioned time points, the difference in hip joint function score between the two groups was statistically significant ( t = 1.89, 2.48, 2.49, all P < 0.001). Conclusion:Both internal fixation methods have significant therapeutic effects on femoral intertrochanteric fractures. Internal fixation using Intertan nails leads to higher hip joint function scores and fewer postoperative complications compared with internal fixation using proximal femoral intramedullary nails, but it results in more blood loss and a longer surgical time.