Clinical Study On Prognosis Of Intertrochanteric Fracture Of Femur

Objective:Currently,significant progress has been made in the diagnosis and treatment of intertrochanteric fractures of the femur,and there is a wealth of literature on the comparison of the efficacy of various surgical approaches.However,few studies have investigated the prognostic factors that affect the postoperative function of intertrochanteric fractures of the femur,resulting in controversies.In this study,we aimed to investigate the factors affecting the recovery of hip function after intertrochanteric femur fractures by collecting data from patients at the Affiliated Hospital of Shandong University of Traditional Chinese Medicine.Our goal is to guide clinical treatment.Additionally,we evaluated the clinical significance of postoperative use of stretching tablets by observing their effect on promoting the recovery of hip function after intertrochanteric femur fractures.Method:1.The study collected demographic(age,gender)and clinical information(fracture subtype,laterality,time from injury to surgery,preoperative albumin level,time to surgery,medical comorbidities)of patients who underwent surgical treatment for intertrochanteric fractures between August 2018 and July 2021 at the Affiliated Hospital of Shandong University of Traditional Chinese Medicine using the hospital’s Big Data search engine.Follow-up assessments were performed using the Harris score of the hip joint as the final assessment index,and patients were divided into two groups for a case-control study.Statistical analysis was performed using SPSS software to identify factors that significantly affected the recovery of hip function after intertrochanteric fracture.2.Sixty patients with intertrochanteric fractures of the femur who underwent PFNA treatment between July 2020 and August 2022 were randomly assigned to the observation or control group.Both groups received conventional treatment,including anti-swelling and pain relief,anti-coagulation,and anti-infection measures.In addition,the observation group was administered shenjin tablets,5 Tid,PO,for 4 weeks as an adjunct to the conventional treatment.The postoperative VAS score and Harris hip score were evaluated in both groups.Results:1.In this study,we collected data from 156 patients with intertrochanteric femur fractures and divided them into a superior group(113 cases)and a non-preferential group(43 cases).After comparing the general data of the patients,variables with statistically significant differences among the 12 prognostic influencing factors were identified,including the use of blood activating and blood stasis type Chinese medicine,age,and history of cardiac and cerebrovascular diseases and respiratory system problems.Further analysis revealed that age,preoperative albumin level,and history of cardiac diseases were risk factors for poor postoperative outcomes,while the perioperative use of herbs for promoting blood circulation and removing blood stasis was a protective factor for postoperative outcomes.Patients with albumin(≥35g/L)had better recovery than those with albumin(<35g/L).No significant differences in functional recovery were found based on gender,time from injury to surgery,time to surgery,type of fracture,or side of injury.2.The baseline characteristics of the two groups were comparable(P >0.05).Compared to the control group,the observation group had significantly lower VAS scores and less pain at 1 and 4 weeks after surgery.Additionally,the Harris scores were significantly higher at 3 months postoperatively,and the difference was statistically significant(P <0.05).No adverse effects were observed in either group.Conclusion:The study found that several factors affect the postoperative function in patients with intertrochanteric fractures.Age was a statistically significant factor,with younger patients having better postoperative function recovery.Patients with a history of combined cardiac diseases had a higher incidence of poor hip function recovery.Patients with fewer than three types of medical comorbidities and higher preoperative albumin levels had better postoperative recovery.The use of blood-activating herbs was found to reduce postoperative pain and was an independent factor influencing postoperative outcome.Similarly,the use of blood-stasis-boosting herbs also helped reduce postoperative pain and was an independent factor influencing postoperative outcome.In this study,the type of fracture,gender,time between injury and surgery,surgery time,and side were not factors affecting postoperative function.It can be concluded that good physical health,adequate nutrition,and timely use of symptomatic herbs can promote the recovery of hip function.Additionally,the use of shenjin tablets may improve hip function after intertrochanteric fracture surgery by reducing pain.