| Objective To explore the clinical efficacy of traditional Chinese bone-setting manipulation reduction combined with PFNA in the treatment of displaced intertrochanteric fracture of femur,and provide a new idea for improving the reduction quality of intertrochanteric fracture of femur during PFNA and the minimally invasive treatment effect of PFNA.Methods Sixty hospitalized elderly patients with intertrochanteric fracture of femur admitted to Wuhu Hospital of Traditional Chinese Medicine from September 2020 to August 2021 were selected,meeting the inclusion and exclusion criteria as well as the fracture classification criteria.According to the admission sequence of the hospitalization system,the hospitalization numbers were numbered,and the cases were divided into observation group and control group with 30 cases each using random number table method.They correspond to group A and B.After the two groups of patients were anesthetized successfully,group A was first reduced by traditional Chinese medicine bone-setting technique under the condition of muscle relaxation and painless.After the fluoroscopic position was satisfied,the lower limb traction frame maintained the position after reduction and PFNA was performed.Group B received traditional PFNA.Reduction time,operation time,incision length,fluoroscopy times,amount of blood loss,absolute difference of bilateral femoral collo-diaphyseal and anteversion angle after operation,internal and external hip inversion,medial wall support of femur,partial loading time and full loading time,VAS score,harris score were collected in the two groups.The differences before and after treatment were compared for statistical analysis.The postoperative complications were also analyzed.Results There was no significant difference in gender,age,affected side,cause of injury,fracture type and other general data between the two groups(P > 0.05).The fracture reduction time,operation time and incision length of group A were shorter than those of group B,and the differences were statistically significant(P < 0.05).The intraoperative blood loss and fluoroscopy times in group A were less than those in group B,and the differences were statistically significant(P < 0.05).Group A was better than group B in the postoperative difference of neck-shaft Angle,difference of anteversion Angle,varus and valgus rate of hip joint,and positive support rate of medial wall of femoral trochanter(P < 0.05).The VAS score,the weight-bearing time of the affected limb,and the fracture healing time of group A were significantly better than those of group B before and after operation(P < 0.05).Both groups were followed up within 6 months after operation.The Harris score of group A was better than that of group B at 1 and 3months after operation,and the difference was statistically significant(P < 0.05),but there was no significant difference between the two groups at 6 months(P > 0.05).Sixty patients had 2 cases of poor wound healing,2 cases of pulmonary infection,1 case of urinary system infection,and the rest had no other complications.Conclusion In this study,in the treatment of femoral intertrochanteric fracture by minimally invasive surgery,the traditional Chinese medicine bone setting manual reduction was performed first under the condition of complete analgesia and no muscle resistance after anesthesia,and PFNA was performed after the fluoroscopy position was satisfactory,which can reduce the number of poor reduction or repeated adjustment during the traditional operation,so as to shorten the reduction time and operation time,and reduce the trauma.To further improve the therapeutic effect of minimally invasive PFNA. |
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