PFNA Treatment Of Early Postoperative Femoral Intertrochanteric Fracture Curative Effect Analysis

Objective: Intertrochanteric fracture is a common clinical disease, the incidence of this disease is high, and it is common in the elderly population,With the aging of population growing in China, the incidence of intertrochanteric fracture is increasing. The patients is mainly in pain, loss of the ambulation ability, and families need long-term care of the patient after getting this disease.The disease can lead to original cardiovascular disease exacerbation as the characteristics, affect the normal life and work. At present,the clinical treatment of intertrochanteric fracture is relatively more, the common include: LCP(proximal locking plate) internal fixation and PFNA internal fixation, these methods can effectively improve the symptoms of patients, improve the clinical efficacy. However, there is still a big controversy in the clinical efficacy of different treatment methods in the elderly patients with intertrochanteric fracture. At the same time, the influence factors of the early treatment of patients with PFNA internal fixation were relatively few.Therefore, it is of great significance to study the influence factors of the early clinical effect of PFNA internal fixation in the treatment of elderly patients with femoral intertrochanteric fracture.Method: Data from 80 patients with intertrochanteric fractures treated in our hospital from September 2013 to December 2014 were retrospectively analyzed. Based on the different fixation method, patients were divided into LCP group and PFNA group. The operation time, incision length, obvious and hidden blood loss, were analyzed comparatively; and Harris score, the rate of complication, and mortality were analyzed comparatively at the last follow up.And logistic regression was used to assess risk factors of early postoperative curative effect on PFNA in the elderly intertrochanteric fractures.Results: The difference between the two groups about sex ratio, age structure, height level, weight levels, cause of injury, medical illness is not significant(P > 0.05). Compared with LCP group, there were less operation time, incision length, obvious blood loss, hospital stay, postoperative healing time in PFNA group, and the difference was statistically significant(P <0.05).The complication rate in PFNA group(Four cases in PFNA group show complications)was 10%, which significantly lower than the LCP group(11cases of complications, the complication rate was 27.5%),(P <0.05); Harris hip score in PFNA group after treatment was significantly higher than LCP group, the difference was statistically significant(P <0.05); The patients in PFNA group after treatment could begin moderate load-bearing exercises earlier than patients in LCP group, the difference was statistically significant(P <0.05); the use of forced entry method of regression analysis, multiple linear regression analysis equation. ANOVA showed F = 15.621, P <0.05, the difference was statistically significant, indicating that hip function and T values, BMI, load time, and is accompanied by a linear relationship between the lesser trochanter fractures. R-square=0.652 R=0.835, that early hip function and the existence of the lesser trochanter fractures, high T value, BMI and patient load time relevance standardized coefficients.Conclusion:(1) The patients with intertrochanteric fractures receiving PFNA and LCP in elderly can achieve the desired effect. However, compared with LCP, PFNA is more minimally invasive, less traumatic to the patient, can obtain better joint function.(2) PFNA treatment of senile intertrochanteric fracture early postoperative hip function and bone density, weight-bearing time, the existence of lesser trochanter fracture, BMI index are closely related.