Clinical Effect of Proximal Femoral Antirotation Intramedullary Nail Combined With Anatomic Locking Plate in the Treatment of Unstable Intertrochanteric Femoral Fractures in the Elderly
Objective To explore the clinical effect of proximal femoral antirotation intramedullary nail combined with anatomic locking plate in the treatment of unstable intertrochanteric femoral fractures in the elderly.Methods Sixty-two elderly patients with unstable intertrochanteric fracture of femur in Putian 95 Hospital from January 2021 to December 2022 were selected as the study objects,and randomly divided into observation group and control group,with 31 cases in each group.The observation group was treated with proximal femoral antirotation intramedullary nailing combined with anatomic locking plate,while the control group was treated with proximal femoral antirotation intramedullary nailing.Compared the perioperative indicators,serum inflammatory factors and bone metabolism levels,hip joint function,and incidence of complications between two groups.Results The operation time[(81.45±11.63)min]in the observation group was longer than that in the control group[(63.71±9.24)min],and the amount of intraoperative blood loss[(165.41±22.74)mL]was longer than that in the control group[(127.82±24.32)mL],weight bearing time[(11.93±2.76)d]and fracture healing time[(10.42±2.07)weeks]were shorter than control group[(15.38±3.59)d,(13.92±2.43)weeks],the differences were statistically significant(t=6.650,6.286,4.242,6.105,P<0.001).One month after the surgery,the levels of interleukin-1,interleukin-6,tumor necrosis factor-α[(39.07±5.37)pg/mL,(32.14±2.72)pg/mL,(30.97±2.16)pg/mL]in observation group were lower than those in control group[(48.14±6.23)pg/mL,(43.66±3.25)p g/m L,(37.32±2.87)pg/mL],the differences were statistically significant(t=6.139,15.135,9.843,P<0.001).One month after operation,the level of carboxyl terminal peptide of typeⅠ collagen in the observation group[(472.91±25.24)ng/L]was lower than that in the control group[(521.46±27.63)ng/L],the level of amino terminal propeptide of typeⅠprocollagen in the observation group[(84.59±9.20)ng/mL]was higher than that in the control group[(73.61±8.64)ng/mL],and the differences were statistically significant(t=7.223,4.844,P<0.001).The excellent rate of hip joint in observation group(93.55%)was higher than that in control group(74.19%),and the difference was statistically significant(χ2=4.292,P=0.038).The complication rate of the observation group(3.23%)was lower than that of the control group(19.35%),and the difference was statistically significant(χ2=4.026,P=0.045).Conclusion Proximal femoral antirotation intramedullary nail combined with proximal femoral anatomic locking plate is effective in the treatment of elderly patients with unstable intertrochanteric fractures,which can alleviate inflammatory response,promote bone repair,inhibit bone resorption,improve hip function and reduce the incidence of complications.
proximal femoral antirotation intramedullary nailintertrochanteric fracture of femuranatomic locking plate for proximal femurcomplicationsinflammatory factorsbone metabolism
万方数据
维普
