Treatment Of Senile Intertrochanteric Fracture With Proximal Femoral Nail Anti-Rotation Intramedullary Nail:Comparison Of Efficacy Between Reamed And Un-Reamed Medulla

Objective To compare and analyze the efficacy of proximal femoral nail anti-rotation intramedullary nail fixation in the treatment of femoral metaphyseal reaming and non-reaming in elderly patients with intertrochanteric fractures.Methods A retrospective analysis was performed on 72 elderly patients with osteoporotic intertrochanteric femoral fractures admitted to our hospital from May 2018 to May 2021.According to whether or not intraoperative femoral metaphyseal reaming was performed,they were divided into un-reamed group(n=34)and reamed group(n=38).The operation time,total blood loss,invisible blood loss,intraoperative blood loss,postoperative drainage volume,blood transfusion rate,length of hospital stay,fracture healing time,incidence of postoperative complications,and Harris hip score at1 month,6 months and 1 year after operation were compared between the two groups.Results There were no significant differences in operation time,intraoperative blood loss,length of hospital stay,fracture healing time,Harris score at 1 month,6 months,and 1 year after operation,and incidence of postoperative complications between the two groups(P>0.05).There were significant differences in total blood loss,invisible blood loss,overt blood loss,postoperative drainage volume and transfusion rate between the two groups(P<0.05).The total blood loss,invisible blood loss,dominant blood loss,postoperative drainage volume and transfusion rate in the non-reaming group were lower than those in the reaming group.Conclusion In elderly patients with intertrochanteric fracture and severe osteoporosis,the treatment of femoral metaphysis without reaming and reaming with PFNA can achieve good postoperative results.However,the non-reaming method can reduce perioperative blood loss and lower postoperative transfusion rate,which is worthy of clinical application.