Application effect of proximal sliding compression technique in patients with intertrochanteric fracture of femur and lateral wall fracture during proximal femoral nail antirotation
Objective To investigate the application value of proximal sliding compression technique in proximal femoral nail anti-rotation(PFNA)in patients with intertrochanteric fracture of femur(IFF)and lateral wall fracture.Methods Fifty patients with IFF and lateral wall fracture admitted to the Department of Orthopedics,the People's Hospital of Bozhou,An-hui Province from August 2019 to August 2021 were selected.According to the random number table method,they were di-vided into experimental group and control group,with 25 cases in each group.PFNA was performed in both groups.The ex-perimental group was treated with proximal sliding compression technique during PFNA,and the control group was treated with conventional PFNA.The perioperative recovery and fracture reduction effect were compared between the two groups.Blood samples were collected before operation,and 3,6 months after operation to detect the levels of serum bone morpho-genetic protein-2(BMP-2)and bone alkaline phosphatase(BALP)in the two groups.The Harris hip score was used to eval-uate the hip function of the two groups on the day of operation,and 3,6,12 months after operation.The changes of femoral neck-shaft angles were compared between the two groups,and the complications were recorded.Another 30 artificial femur specimens were selected and numbered,and divided into PFNA group and proximal sliding compression technique combined with PFNA group according to the random number table method,with 15 cases in each group.After the corresponding inter-vention,the torsional load test and the compression load test were used to compare the torsional stiffness and torque at 1.5° torsion,and the compression stiffness and displacement at 800 N load.Results The fracture healing time of the experimental group was shorter than that of the control group(P＜0.05).The levels of serum BMP-2 and BALP in the two groups at 3,6 months after operation were higher than those before operation,and those at 6 months after operation were higher than those at 3 months after operation,the levels of serum BMP-2 and BALP in the experimental group at 3,6 months after operation were higher than those in the control group at the same period(P＜0.05).The Harris scores of the two groups at 3,6,12 months after operation were higher than those on the day after operation,those at 6,12 months after operation were higher than those at 3 months after operation,the Harris scores of the experimental group at 3,6 months after operation were higher than those of the control group at the same period(P＜0.05).The femoral neck-shaft angles of two groups at 3,6,and 12 months after operation were lower than those on the day after operation(P＜0.05).There was no significant difference in re-duction effect and total complication rate between the two groups(P＞0.05).Compared with the PFNA group,the proximal sliding compression technique combined with PFNA group had significantly higher torsional stiffness and torque at 1.5°tor-sion,significantly higher compression stiffness at 800 N load,and significantly lower compression displacement(P＜0.05).Conclusion The proximal sliding compression technique in PFNA can promote the fracture healing and functional recovery of patients with IFF and lateral wall fracture,and has better biomechanical properties.
Lateral wall fractureIntertrochanteric fracture of femurProximal femoral nail antirotationSliding compres-sion technique
NETL
NSTL
万方数据
