Analysis of efficacy and prognostic factors of hyperbaric oxygen combined with intramedullary nail internal fixation in the treatment of femoral intertrochanteric fractures
Objective To explore the influencing factors of the efficacy and prognosis of hyperbaric oxygen combined with intramedullary nail internal fixation in the treatment of femoral intertrochanteric fractures.Methods A total of 102 patients with intertrochanteric fracture of femur,who were treated in The First People's Hospital of Shangqiu from May 2018 to June 2020 and followed up until June 2021,were selected as the study objects.All patients were treated with hyperbaric oxygen combined with intramedullary nail internal fixation.The curative effect,operation time,and intraoperative blood loss were observed.The Harris hip function score and Sanders post-traumatic hip function score were compared before surgery,3 months after surgery,6 months after surgery,and at the last follow-up.According to the results of the last follow-up,the patients were divided into the poor prognosis group(Harris hip function score＜70,Sanders hip function score ≤44,n=26)and the good prognosis group(Harris hip function score ≥70,Sanders hip function score＞44,n=76).A binary Logistic regression model was used to analyze the risk factors affecting the prognosis of patients with femoral intertrochanteric fracture.Results The total effective rate of 102 patients with femoral intertrochanteric fracture was 76.47％(78/102).The operative time was(43.25±10.05)min and the intraoperative blood loss was(142.52±25.32)ml.Harris hip function scores and Sanders hip function scores after surgery at 3 months,6 months,and the last follow-up were higher than those before surgery(P＜0.05).There was no statistically significant difference in gender,age,fracture classification,preoperative underlying disease,causes of injury,and time from injury to operation between the poor prognosis group and the good prognosis group(all P＞0.05).There were statistically significant differences in bone mineral density,nutritional status,American Society of Anesthesiologists(ASA)grade,postoperative complications,tip-apex distance,postoperative rehabilitation training,and other baseline data between the two groups(all P＜0.01).Binary Logistic regression analysis showed that bone mineral density＜-2.5 SD,albumin＜30 g/L,ASA grade 3-4,postoperative complications,tip-apex distance＞25 mm,and no postoperative rehabilitation training were independent risk factors affecting the prognosis of patients with femoral intertrochanteric fractures(P＜0.05).Conclusion Hyperbaric oxygen combined with intramedullary nail internal fixation has a certain therapeutic effect on the treatment of femoral intertrochanteric fracture.In clinical practice,attention should be paid to the influence of factors on prognosis,such as bone mineral density,nutritional status,ASA grade,postoperative complications,tip-apex distance,and postoperative rehabilitation training.
Hyperbaric oxygenIntramedullary nail internal fixationIntertrochanteric fracture of femurCurative effectPrognosis:Multifactor
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