Application of small trochanteric fixation and bone cement reinforcement in osteoporotic intertrochanteric fracture of femur
Objective To explore the biomechanical study and comparison of small trochanter fixation and bone cement reinforcement on the stability of proximal femoral nail antirotation(PFNA)internal fixation after the treatment of A2-type osteoporotic intertrochanteric femoral fractures in the elderly.Methods Twenty-four elderly osteoporotic femoral specimens were selected to create an unstable A2-type intertrochanteric fracture model.According to the random number table method,they were divided into three groups:bone cement reinforcement group(n=8),small trochanter fixation group(n=8),and control group(n=8).In the bone cement reinforcement group,after the completion of PFNA fixation,bone cement was injected through the hollow channel of the spiral blade.In the small trochanter fixation group,after the completion of PFNA fixation,a cerclage wire was placed on the top of the small trochanter bone block,and after tightening the lateral femur,the small trochanter area was fixed.The control group was only given PFNA fixation.The biomechanical machine was used to analyze the fracture end distance,displacement(sliding displacement,compressive displacement),and load-bearing capacity(ultimate load force,maximum load force)of the three groups,and analyzed the impact of different assistive techniques on the stability of the fracture after intramedullary nail fixation.Results After compression,the fracture end distances in the bone cement reinforcement group and the small trochanter fixation group were all greater than that in the control group,and the differences were all statistically significant(all P<0.05),but there was no significant difference between the bone cement reinforcement group and the small trochanter fixation group(P>0.05).The compressive displacements in the bone cement reinforcement group and the small trochanter fixation group were all lower than that in the control group,and the differences were statistically significant(all P<0.05),but there was no significant difference between the bone cement reinforcement group and the small trochanter fixationgroup(P>0.05).The sliding displacements in both the bone cement reinforcement group and the small trochanter fixation group were lower than that in the control group,and the sliding displacements in the small trochanter fixation group were lower than that in the bone cement reinforcement group,with all differences being statistically significant(all P<0.05);the ultimate load force and maximum load force in both the bone cement reinforcement group and the small trochanter fixation group were all higher than those in the control group,with the differences being statistically significant(all P<0.05),while there was no significant difference between the bone cement reinforcement group and the small trochanter fixation group(P>0.05).Conclusions Compared to conventional PFNA,bone cement-reinforced PFNA and small trochanter fixed PFNA can effectively increase the stability of the fracture ends in unstable A2-type intertrochanteric fractures in the elderly,allowing for early weight-bearing,and the small trochanter fixed PFNA is more effective in preventing sliding displacement of the fracture ends.Clinically,appropriate auxiliary techniques can be used in conjunction with the specific conditions of the patient.
Small trochanter fixationBone cement reinforcementOsteoporosisIntertrochanteric femoral fractureIntramedullary nail fixationStability
万方数据
维普
