Comparison of Short-term and Long-term Efficacy and Complications of Different internal Fixation Methods in the Treatment of Elderly Patients with Unstable Intertrochanteric Fracture of Femur
Objective:To analyze the short-term and long-term efficacy and complications of different internal fixation in the treatment of elderly patients with unstable intertrochanteric fracture of femur(IFF).Methods:60 elderly patients with unstable IFF admit-ted to our hospital from January 2020 to January 2023 were selected as research samples.According to different surgical methods,they were divided into two groups,including 30 cases in PF-LCP group(receiving PF-LCP surgery)and 30 cases in PFNA group(receiving PFNA internal fixation surgery).The surgical conditions,hip function(HHS),bone metabolism indexes and inflammatory factors levels[type Ⅰ procollagen amino terminal peptide(PINP),type Ⅰ collagen carboxy terminal peptide(CTX),serum interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)],quality of life and complications were compared between the two groups.Results:The surgical time,hospital stay and fracture healing time in the PFNA group were shorter than those in PF-LCP group,and the intraoperative blood loss was less(P＜0.05).The HHS score of the two groups at 3 months,6 months and 12 months after surgery was gradually higher than that before surgery,and the HHS scores in the PFNA group at 3 months and 6 months after surgery were higher than those in the PF-LCP group(P＜0.05).There was no significant difference in HHS score between the two groups at 12 months after surgery(P＞0.05).The PINP level in the two groups at 6 months after surgery was higher than that before surgery,and the PFNA group had higher PINP level than the PF-LCP group(P＜0.05).The levels of CTX,IL-6 and TNF-α were reduced than those before surgery,and the levels in the PFNA group were lower(P＜0.05).At 12 months after surgery,the quality of life scores of the two groups were higher than before surgery,and the PFNA group had higher scores than the PF-LCP group(P＜0.05).After 12 months of follow-up,there were 4 cases of internal fixation failure in PFNA group(including 3 cases of main nail fracture and 1 case of screw blade withdrawal),and the failure rate was 13.33％.There was no case of internal fixation failure in PF-LCP group,and the failure rate of internal fixation in PFNA group was higher than that in control group(P＜0.05).There was no significant difference in the total incidence of other postoperative complications between the two groups(P＞0.05).Conclusion:Both PFNA and PF-LCP can effectively treat unstable IFF in the elderly.Compared with PF-LCP,PFNA has faster postoperative recovery and better short-term efficacy,but the risk of internal fixation failure is relatively greater.
Internal fixationProximal femoral nail anti-rotationLocking plateElderlyUnstable intertrochanteric fracture of femurEfficacyComplications
NETL
NSTL
万方数据
