Factors Influencing The Failure Of Internal Fixation In Medial Wall Unstable Intertrochanteric Fractures After PFNA Treatment

Objective: The aim was to investigate the factors influencing the failure of internal fixation of medial wall unstable intertrochanteric fractures after proximal femoral rotation-proof intramedullary nailing(PFNA)internal fixation treatment.Methods:Retrospective analysis of clinical data of patients with Evans-Jensen fraction type IV and V intertrochanteric femur fractures admitted to the Department of Orthopedic IV of the Fourth Affiliated Hospital of Xinjiang Medical University from January 2018 to December 2021,including gender,age,fracture side,injury energy,fracture to surgery time,combined medical disease,combined osteoporosis,anesthesia mode,surgery time,intraoperative bleeding,internal fixation method,and quality of repositioning.Through outpatient or telephone follow-up,hip inversion deformity,bone discontinuity,or loosening of internal fixation within one year after surgery were included in the internal fixation failure group,and the rest were included in the effective internal fixation group.Variables were first screened using univariate analysis,and those with P < 0.05 were included in the multivariate logistic regression analysis,and those with P < 0.05 in the multivariate logistic results were the influencing factors of internal fixation failure.Results: After screening according to the inclusion and exclusion criteria,a total of 144 patients with inter-rotor fractures were included in the study,21 patients were included in the internal fixation failure group and 123 patients were included in the effective internal fixation group.After univariate and multifactorial logistic regression analyses,the results showed that comorbid medical disease,comorbid osteoporosis,mode of internal fixation,and quality of reduction were the influential factors affecting internal fixation failure after inter-rotor fracture surgery.Conclusions: Postoperative internal fixation failure of posterior medial wall unstable intertrochanteric fractures is influenced by a variety of factors,and clinically orthopedic surgeons should develop reasonable and effective solutions for high-risk patients.