骨水泥灌注联合PFNA内固定及单纯PFNA术治疗骨质疏松性老年股骨粗隆间骨折的比较

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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.

Key words： intertrochanteric fracture of femur old age osteoporosis bone cement perfusion proximal femoral nail anti-rotation

Received: 09 October 2022

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	FENG Dongqian
	ZHANG Bin
	YU Jiasheng
	BAO Lei
	XIN Bing

Cite this article:

FENG Dongqian,ZHANG Bin,YU Jiasheng等. Comparison of cement perfusion combined with PFNA internal fixation and PFNA alone in the treatment of osteoporotic intertrochanteric fractures in the elderly[J]. HuNan ShiFan DaXue XueBao(YiXueBan), 2023, 20(1): 68-71.

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http://yxb.hunnu.edu.cn/EN/ OR http://yxb.hunnu.edu.cn/EN/Y2023/V20/I1/68

[1] Liu J, Zeng L, Wang X, et al.Application of bandage stretching on the femoral intertrochanteric fracture treated with distal end poking by Hoffman's hook.[J]. Asian journal of surgery, 2021, 44(8): 1129-1130.
[2] Mccloskey E, Rathi J, Heijmans S, et al.The osteoporosis treatment gap in patients at risk of fracture in European primary care: a multi-country cross-sectional observational study[J]. Osteoporosis International, 2021, 32(2): 251-259
[3] Chang S M, Hou Z Y, Hu S J, et al.Intertrochanteric Femur Fracture Treatment in Asia: What We Know and What the World Can Learn[J]. Orthopedic Clinics of North America, 2020, 51(2): 189-205.
[4] Hao Z, Wang X, Zhang X .Comparing surgical interventions for intertrochanteric hip fracture by blood loss and operation time: a network meta-analysis.[J]. J Prthop Surg Res, 2018, 13(1): 157.
[5] Fan S, Yin M, Xu Y, et al . Locking compression plate fixation of femoral intertrochanteric fractures in patients with preexisting proximal femoral deformity: a retrospective study.[J]. J Orthop Surg Res, 2021, 16(1): 285-285.
[6] 刘颗星, 邓颂波, 曾日祥, 等. 特立帕肽在老年性股骨粗隆间骨折保守治疗中对骨密度的影响及其临床疗效[J]. 临床与病理杂志, 2019, 39(12): 2733-2739.
[7] Wang C, Wang Q .Helical blade compression failure occurred during PFNA implantation: A rare case and ingenious solution[J]. Medicine, 2019, 98(30): e16584.
[8] Li K, Yang H, Jiang Z, et al.Effect of proximal femoral nail antirotation on clinical outcome, inflammatory factors and myocardial injury markers in patients with femoral trochanteric fracture[J]. Am J Transl Res, 2022, 14(7): 4795-4803.
[9] 胡捷斯, 杨继梅, 鲁晓波, 等. 股骨头缺血性坏死患者髋关节X线检查相关参数与Harris评分的关系[J]. 山东医药, 2018, 58(20): 75-77.
[10] Dixon J S, Bird H A .Reproducibility along a 10 cm vertical visual analogue scale.[J]. Ann Rheum Dis, 1981, 40(1): 87-89.
[11] 王武, 翟生, 韩小平, 等. 股骨近端抗旋髓内钉与动力髋螺钉对老年不稳定股骨粗隆间骨折疗效的对比研究[J]. 中华医学杂志, 2018, 98(5): 357-361.
[12] 袁梅, 孙悦, 刘乔, 等. 抗骨质疏松药物联合手术治疗老年股骨粗隆间骨折[J]. 中国矫形外科杂志, 2021, 29(12): 1139-1141.
[13] Mu J X, Xiang S Y, Ma Q Y, et al . Selection of internal fixation method for femoral intertrochanteric fractures using a finite element method.[J]. World J Clin Cases, 2021, 9(22): 6343-6356.
[14] 宋矿朋, 刘向林, 马超. INTER-tan与PFNA内固定治疗老年股骨粗隆间骨折的疗效及安全性分析[J]. 重庆医学, 2021, 50(14): 2485-2488.
[15] 刘永起. PFNa与股骨近端解剖型锁定钢板治疗老年股骨粗隆间骨折的临床研究[J]. 中国全科医学, 2019, 22(2): 93-95.
[16] 张景涛, 雷卫军, 周广伟. PFNA和LPFP在老年股骨粗隆间骨折治疗中的疗效比较[J]. 中国老年学杂志, 2019, 39(24): 6001-6003.
[17] 陈坚锋, 潘耀成, 冯宗权. 骨水泥型半髋关节置换治疗高龄不稳定性股骨粗隆间骨折[J]. 中国矫形外科杂志, 2020, 28(10): 949-951.
[18] 钱玉, 史航, 朱爱祥, 等. 普通型与骨水泥强化型股骨近端防旋髓内钉治疗老年股骨粗隆间骨折的对比研究[J]. 东南大学学报 (医学版), 2021, 40(2): 189-194.
[19] 陈宏峰, 杨冬松, 凌建生, 等. 骨水泥强化型股骨近端防旋髓内钉固定治疗严重骨质疏松性股骨转子间骨折[J]. 中华创伤骨科杂志, 2020, 22(3): 259-262.