Effectiveness of anti rotation proximal femoral nail fixation and joint replacement in the treatment of intertrochanteric fractures of the femur
Objective To explore the effectiveness of anti rotation proximal femoral nail(PFNA)fixation and joint replacement in the treatment of intertrochanteric fractures of the femur.Methods Total-ly,104 patients with intertrochanteric fractures of the femur admitted to our hospital from January 2019 to December 2022 were selected as the research subjects.According to the surgical methods,the patients were divided into a PFNA group and a joint replacement group,with 52 patients in each group.The PFNA group patients were treated with anti rotation PFNA fixation,and the joint replacement group patients were treated with artificial total hip replacement.The surgical outcomes of surgical methods were compared.The postoperative complete weight-bearing time,visual analogue scale(VAS),hip range of motion(ROM),hip joint function recovery(Harris score),and incidence of postoperative complications were evaluated.The comparison of inter group measurement data was done by thet-test.Results The operation time,sur-gical bleeding volume,postoperative drainage volume,and fracture healing time in the PFNA group[(85.83±7.93)min,(242.54±17.35)ml,(129.35±12.43)ml,(124.86±9.81)d,(11.37± 1.99)d]were significantly increased as compared with those in the joint replacement group[(69.67± 6.10)min,(185.88±15.73)ml,(96.08±12.75)ml,(96.46±11.22)d,(7.17±1.00)d,t=11.640,17.440,13.740,13.040,13.560,P＜0.05].The VAS score(2.81±0.89)and hip flexion and extension ROM[(118.65±7.51)°]in the PFNA group were significantly decreased as compared with those in the joint replacement group[(2.06±0.73)and(130.54±6.89)°,t=4.722,8.409,P＜0.05].The hip joint function in the PFNA group[(69.10±5.09)score]was significantly lower than that in the joint replacement group[(80.27±4.62)score,t=11.710,P＜0.05].The levels of inflammatory factors(TNF-α and IL-6)[(24.56±3.71)pg/ml and(48.69±3.71)pg/ml]in the joint replacement group were significantly lower than those in the PFNA group after treatment[(30.22±2.17)pg/ml,(58.65±4.01)pg/ml,t=4.581,5.008,P＜0.05].The incidence of internal fixation complications and hip joint complications in the joint replacement group[1.92％(1/52)]was significantly lower than that in the PFNA group[9.61％(5/52),x2=2.216,P＜0.05].Conclusion The treatment of intertro-chanteric fractures with artificial total hip arthroplasty is effective,with short postoperative hospital stay,low incidence of complications,and significant improvement in postoperative pain and joint function.
Anti rotation proximal femoral nail fixation surgeryJoint replacement surgeryIn-tertrochanteric fracture of femurHip joint function
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