Study On The Differences In Treatment Of Thigh Pain After Femoral Neck Fracture Surgery With Pfna Of Different Lengths

Objective:To explore the impact of the length of the main nail of the proximal femoral nail antirotation(PFNA)on the stress of the distal femur and thigh pain after surgery for elderly femoral neck fractures.Methods:Selecting 98 patients who underwent unilateral PFNA treatment from October2020 to June 2022 and met the inclusion criteria as the study subjects,they were divided into three groups based on the length of the main nail of the PFNA.Among them,35 cases had a main nail length of 170mm(ultra-short nail group),33 cases had a main nail length of 200mm(short nail group),and 30 cases had a main nail length of240mm(long nail group).The baseline data of age,gender,fracture side,BMI,AO classification,and ASA classification were compared among the three groups.The distance(d)between the tip of the main nail and the anterior cortex of the femur and the incidence of nail tip impingement with the anterior cortex of the femur were measured and compared on the postoperative follow-up radiographs of the femoral lateral view in the three groups.The Oswestry Disability Index(ODI)and Numerical Rating Scale(NRS)were followed up and compared among the three groups postoperatively.Results:1.There was no significant difference in the baseline data,including age,gender,fracture side,BMI,AO classification of the fracture,and ASA classification,among the three groups(P>0.05).2.There was a significant difference in the distance from the tip of the nail to the anterior cortex of the femur and the occurrence of nail tip contact with the anterior cortex of the femur between the long nail group and the ultra-short nail group and the short nail group(P<0.05),but there was no significant difference between the ultra-short nail group and the short nail group(P>0.05).3.There was a significant difference in the ODI and NRS scores between the long nail group and the ultra-short nail group and the short nail group(P<0.05),but there was no significant difference between the ultra-short nail group and the short nail group(P>0.05).Conclusion:In the treatment of intertrochanteric fractures in elderly patients with PFNA internal fixation,a shorter main nail length has the advantage of avoiding contact with the medial cortex of the femur,thereby reducing the concentrated stress on the distal femur and reducing the occurrence of thigh pain after surgery.