| BackgroundHip fracture is a common and exacerbating condition in older people,especially in older women.Epidemiological data vary by country and region.Globally,it is estimated that hip fracture will affect approximately 18% of women and 6% of men.Although the age-standardized incidence rate is gradually declining in many countries,it far outpaces the aging of the population.The direct costs associated with this disease are significant,as it requires long hospital stays and subsequent rehabilitation.In addition,hip fractures are associated with the development of other negative diseases,such as disability and cardiovascular disease,which impose additional costs on society.In the last century,due to the underdevelopment of economy and medical treatment,patients with hip fracture often take conservative treatment.Conservative treatment has caused great pain to patients physically and psychologically,and the complications brought by it have led to an increase in mortality.In recent years,with the improvement of internal fixation materials and surgical methods,the level of perioperative diagnosis and treatment and surgical safety have been significantly improved,and the concept of rapid rehabilitation surgery has been proposed.The indications for surgical treatment have also been considerably expanded.Most of the patients with intertrochanteric fracture of the femur are now advocated for early surgical treatment.Surgical treatment can make patients get out of bed early,reduce the complications caused by a long time in bed,and improve the quality of life of patients.Therefore,it is of great clinical significance to explore the clinical effect of different surgical methods in the treatment of femoral intertrochanteric fracture in the elderly ObjectiveTo investigate the clinical effects of different surgical methods including dynamic hip screw(DHS),proximal femoral locking plate(PFLP),proximal femoral nail anti-rotation(PFNA)and hemiarthroplasty(HA)in the treatment of intertrochanteric fracture.MethodsDuring March 2017 to January 2020 in the second affiliated hospital of zhengzhou university orthopaedic application of dynamic hip screw DHS,proximal femoral locking plate PFCP,proximal femoral nail anti-rotation PFNA,hemiarthroplasty HA therapy in elderly patients with femoral intertrochanteric fracture,171 cases were retrospectively analyzed,including the DHS group 45 cases,LCP group of 41 cases,PFNA group of 42 cases,HA group 43 cases through medical records,follow-up outpatient care,telephone,Internet and other way,The operative time,intraoperative blood loss,incision length,length of hospital stay,length of weight-bearing,Harris score of hip joint function and postoperative complications of each patient were recorded.ResultsPFNA group was better than DHS group and LCP group in the operation time,the differences were statistically significant(P <0.05),the PFNA group and HA group in the average time was longer,but the difference was not statistically significant(P>0.05).In weight-bearing time,postoperative 1 month and 6 months after Harris scoring,PFNA group is better than that of DHS,PFLP group,the difference had statistical significance(P < 0.05)and joint replacement is better than that of internal fixation group,the difference is statistically significant(P < 0.05)in three groups in hospital stay,and postoperative function Harris hip score 12 months is no statistical difference(P < 0.05);The postoperative complications were 11.1% in the DHS group,7.3% in the PFLP group,2.4% in the PFNA group and 4.6% in the HA group.There was no statistical difference between the two groups ConclusionCompared with DHS/LCP system,PFNA has the characteristics of less trauma,simple operation,quick postoperative recovery and fewer complications,and shows good clinical efficacy in the treatment of intertrochanteric fracture.hemiarthroplasty can shorten the time of lower movement and improve the early hip movement function... |
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