Clinical effect of posteromedial wall fracture reduction and fixation on PFNA in the treatment of intertrochanteric fracture of femoral complicated with posteromedial wall fracture
Objective To explore the clinical effect of medial wall fracture block reduction and fixation on proximal femoral nail antirotation(PFNA)in the treatment of posterior medial wall fracture of intertrochanteric fracture of femur.Methods The data of 64 patients with intertro-chanteric fracture of femur and posterior medial wall fracture admitted to Shuyang County Hos-pital of Traditional Chinese Medicine from January 2020 to January 2022 were analyzed retro-spectively.All patients were treated with PFNA,and they were divided into non reduction group(n=29 cases)and reduction group(n=35 cases)according to receive or not to receive reduction and fixation of medial wall fracture block.The operation time,intraoperative blood loss,hospitalization time,weight bearing time,fracture healing time,hip joint mobility,visual analog pain score(VAS),hip joint function score,lower limb function score and complications of the two groups were compared.Results The operation time in the reduction group was lon-ger than that in the non reduction group(P＜0.05).There was no significant difference in the amount of bleeding in both groups(P＞0.05).The hospitalization time,weight bearing time and fracture healing time of patients in the reduction group were shorter than those in the non reduction group(P＜0.05).Six months after operation,the flexion,extension,abduction and adduction of the hip joint in the two groups were increased compared with that in one month af-ter operation(P＜0.05),and the flexion,extension,abduction and adduction of the hip joint in the reduction group were higher than those in the non reduction group(P＜0.05).After 3 months of operation,VAS scores of patients in both groups were decreased compared with that in 10 days after operation(P＜0.05),and VAS scores of patients in reduction group were low-er than those in non reduction group(P＜0.05).Six months after operation,the hip joint function score and lower limb function score of patients in both groups increased compared with that in one month after operation(P＜0.05),and the hip joint function score and lower limb function score of patients in the reduction group were higher than those in the non reduction group(P＜0.05).There was no significant difference in the incidence of complications be-tween the two groups(P＞0.05).Conclusion The reduction and fixation of medial wall frac-ture block can be used for PFNA treatment of patients with medial wall fracture after intertro-chanteric fracture of femur,and it can accelerate postoperative recovery,reduce postoperative pain,improve hip joint and lower limb function,and it is safe and reliable.
posteromedial wall fracturefracture reductionproximal femoral anti rotation intr-amedullary nailintertrochanteric fracture of femur
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