Comparison of Effect of Joint Replacement and PFNA Internal Fixation in the Treatment of Elderly Patients with Femoral Intertrochanteric Fractures
Objective:To compare the effect of joint replacement and proximal femoral nail antirotation(PFNA)internal fixation on elderly patients with femoral intertrochanteric fractures(FIF).Method:A total of 82 elderly patients with FIF admitted to the Second People's Hospital of Jingdezhen from January 2020 to December 2022 were included,and randomly divided into replacement group and PFNA group,with 41 cases in each group.The replacement group was treated with joint replacement,and the PFNA group was given PFNA internal fixation.The surgery-related indicators(surgical time,intraoperative blood loss volume,postoperative off-bed activity time)were compared.Swelling degree of the affected limb before surgery and at 7 days after surgery were compared.Self-care ability[functional independence measure(FIM)]and hip function[Harris hip score(HHS)]before surgery and at 3 months after surgery and total incidence rate of complications(incision infection,pressure sores,venous thrombosis)within 3 months after surgery were compared between the two groups.Result:The surgery time of PFNA group was shorter than that of replacement group,and the intraoperative blood loss volume was less than that of replacement group,the postoperative off-bed activity time was significantly later than that in replacement group,the differences were statistically significant(P<0.05).The swelling degree of the affected limb in both groups at 7 days after surgery were significantly milder than those before surgery,and the swelling degree was milder in PFNA group than that in replacement group,the differences were statistically significant(P<0.05).At 3 months after surgery,FIM score and HHS in both groups were significantly higher than those before surgery,and compared with PFNA group,FIM score and HHS in replacement group were higher,the differences were statistically significant(P<0.05).Three months after surgery,there was no significant difference in the total incidence of complications between the two groups(P>0.05).Conclusion:In the clinical treatment of elderly patients with FIF,PFNA has shorter surgical time,less intraoperative blood loss volume and milder swelling degree of the affected limb,but joint replacement has better recovery of hip function and self-care ability.
Joint replacementProximal femoral nail antirotation internal fixationElderly femoral intertrochanteric fracturesFunctional independenceHip function
万方数据
维普
