Risk factors for hip joint dysfunction after PFNA internal fixation surgery for intertrochanteric fractures of the femur
Objective To explore the risk factors of hip joint dysfunction after proximal femoral anti rotation intramedullary nail(PFNA)internal fixation for the treatment of intertrochanteric fractures of the femur.Methods 50 patients with intertrochanteric frac-ture of femur treated with PFNA internal fixation were divided into good effective group(n=30)and ineffective group(n=20)accord-ing to Harris hip function score(Harris).The demographic data and clinical indicators of the two groups were collected and compared,and ROC curve was analyzed for the value of relevant indicators in predicting hip function of patients with intertrochanteric fracture trea-ted with PFNA.The risk factors of hip dysfunction in patients with intertrochanteric fracture of femur was analyzed by using multivariate logistic regression.Results Body mass index(BMI)of ineffective group was higher than that of good effective group,the proportion of osteoporosis was higher than that of good group,the apex distance was greater than that of good effective group,the proportion of external wall type Ⅰ was higher than that of good effective group,and the external wall thickness was lower than that of good effective group(P＜0.05).ROC analysis confirmed that BMI,apex distance and lateral wall thickness predicted the hip area under the functional curve of pa-tients with intertrochanteric fracture treated with PFNA,0.713,0.777 and 0.738,respectively(P＜0.05).Multivariate logistic regression analysis confirmed that BMI≥26.18 kg/m2,combined osteoporosis,apical distance ≥25.02 mm,lateral wall type Ⅱ or Ⅲ,and lateral wall thickness ≤2.20 mm were risk factors for hip dysfunction in patients with intertrochanteric fracture treated with PFNA(P＜0.05).Conclusion The high risk factors of hip dysfunction in patients with intertrochanteric fracture treated with PFNA include BMI,osteopo-rosis,apex distance,lateral wall classification and lateral wall thickness.
Intertrochanteric fracture of femurInternal fixation of proximal femoral antirotation intramedullary nailHip func-tionRisk factor
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