Comparison of cement perfusion combined with PFNA internal fixation and PFNA alone in the treatment of osteoporotic intertrochanteric fractures in the elderly
FENG Dongqian1,2, ZHANG Bin2, YU Jiasheng2, BAO Lei2, XIN Bing1
1. Orthopedics department, Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, China; 2. Orthopedics department, Shuyang Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Shuyang 223600, China
Abstract：Objective To compare the efficacy of bone cement perfusion combined with proximal femoral nail anti-rotation (PFNA) internal fixation and PFNA alone in the treatment of osteoporotic intertrochanteric fractures in the elderly. Methods A total of 96 elderly patients with osteoporotic intertrochanteric fracture admitted to our hospital from January 2019 to December 2021 were included in the study and divided into observation group and control group by random number table method, with 48 cases in each group. The control group was treated with PFNA internal fixation, while the observation group was treated with bone cement perfusion combined with PFNA internal fixation. Recorded and compared the perioperative indicators of the two groups, evaluated the hip function of the patients at 1 month, 3 months and 6 months after operation through Harris Hip scale, evaluated the pain degree of the patients before operation, 1 month, 3 months and 6 months after operation through Visual analogue scale (VAS), recorded postoperative complications in the two groups, and calculated the total incidence of complications. Results The intraoperative blood loss, length of hospital stay and postoperative weight-bearing time in the observation group were significantly lower than those in the control group, and the operation time in the observation group was significantly longer than that in the control group. There was no significant difference in postoperative blood loss between the two groups. Compared with 1 month after operation, the Harris score of the observation group and the control group was significantly increased at 3 months and 6 months after operation, and the Harris score of the observation group was significantly higher than that of the control group at 1 month, 3 months and 6 months after operation. The VAS scores of the observation group and the control group at 1 month, 3 months and 6 months after operation were significantly decreased compared with those before operation, and the VAS scores of the observation group at 1 month, 3 months and 6 months after operation were significantly lower than those of the control group. There was no significant difference in the total incidence of complications between the two groups. Conclusion Bone cement perfusion combined PFNA internal fixation in the treatment of osteoporotic elderly femoral intertrochanteric fracture curative effect is better than that of pure PFNA treatment, patients can significantly reduce intraoperative blood loss, shorten the patients' hospitalization duration, down load time, at the same time can effectively improve the function of patients with hip, relieve patients' pain, and has high security, have clinical application value.
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2023, Vol. 20 
