Clinical effect of different internal fixation methods in the treatment of elderly patients with intertrochanteric fracture and its influence on postoperative bone metabolism
Objective To explore the clinical effect of three-nails and proximal femoral nail anti-rotation(PFNA)internal fixation in the treatment of elderly patients with intertrochanteric fracture.Methods A total of 56 patients with intertrochanteric fracture admitted in Wuxi Xishan People's Hospital from January 2022 to January 2023 were selected as the research objects.According to the difference of internal fixation methods,the patients were divided into three-nails group(21 cases,three-nails internal fixation)and PFNA group(35 cases,PFNA internal fixation).Bone metabolism,pain degree,hip joint function,fracture healing and complications were compared between the two groups.Results At 1 and 3 months after operation,the bone mineral density and osteocalcin level in the PFNA group were higher than those in the three-nails group(P<0.05);at 1,3 and 6 months after operation,the bone mineral density and osteocalcin level of the two groups gradually increased,and the increase in the PFNA group was more obvious(P<0.05).At 1 week and 1 month after operation,the Visual Analogue Scale(VAS)score of the PFNA group was lower than that of the three-nails group(P<0.05);the VAS score of the two groups decreased gradually from 1 week after operation,and the pain relief in the PFNA group was faster.At 1,3,6 months after operation and at the last follow-up,the Harris score of the PFNA group was higher than that of the three-nails group(P<0.05).The fracture healing time of the PFNA group was shorter than that of the three-nails group(P<0.05).The total incidence of complications in the PFNA group was lower than that in the three-nails group,but the difference was not statistically significant(P=0.22).Conclusion Three-nails or PFNA internal fixation can promote bone metabolism,relieve pain and restore joint function in elderly patients with intertrochanteric fractures,but PFNA internal fixation has better effect.
intertrochanteric fractureproximal femoral nail anti-rotationbone mineral densityosteocalcinbone metabolism
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