The effect of two surgical methods on the postoperative recovery of hip joint function in elderly patients with femoral intertrochanteric fractures complicated by lateral wall fractures
Objective To investigate the impact of the application of proximal femoral antirotation intr-amedullary nail(PFNA)combined with locking plate internal fixation and artificial femoral head replacement(FHR)on the postoperative hip joint function in elderly patients with intertrochanteric fractures complicated by lateral wall fractures.Methods 41 elderly patients with femoral intertrochanteric fractures combined with lateral wall fractures were randomly divided into two groups.In the internal fixation group,after PFNA fixa-tion,a pre-bent 3.5 mm screw hole locking plate was used to fix the lateral wall.The other group underwent FHR with a distal fixation biologic prosthesis,and the lateral wall fracture block was fixed using a tension band lashing technique.Both groups were followed up for evaluation postoperatively.Results All patients were successfully followed up for an average of(7.21±2.43)months.The incision length and intraoperative blood loss in the internal fixation group were superior to those in the FHR group(P＜0.001).The operation time in the FHR group was shorter than that in the internal fixation group(P＜0.05).The FHR group showed supe-rior performance in the time of the first postoperative weight-bearing(assisted with a walker),the time of postoperative walking(assisted with a walker),and the Harris score 1 month after surgery compared to the in-ternal fixation group(P＜0.001).There was no statistically significant difference between the two groups in postoperative complications and the occurrence of Trowel gait.Conclusion For the surgical treatment of in-tertrochanteric fractures in elderly patients with lateral wall involvement,distal fixation with a biological FHR achieves earlier mobilization and weight-bearing times,resulting in better early joint function recovery.Despite increased surgical difficulty,this approach is still worth promoting and applying.
hip fractureslateral wallold agefemoral head replacementproximal femoral antirotation intramedullary nail
万方数据
维普
