Application of parathyroid hormone combined with low frequency pulse electromagnetic field in elderly patients with intertrochanteric fracture

Abstract

Objective To investigate the effect of parathyroid hormone (PTH) mimicker teriparatide acetate combined with low frequency pulse electromagnetic field(LFPEF)on hip function and fracture healing in elderly osteoporosis patients with intertrochanteric fracture after PFNA. Methods Forty-eight elderly patients with femoral intertrochanteric fracture treated by PFNA in our hospital from May 2016 to May 2018 were randomly divided into control group (n=24) and observation group (n=24) according to different treatment methods. The control group was treated with PTH after operation, while the observation group was treated with PTH combined with LFPEF after operation. The hip joint function, fracture healing, biochemical indexes of bone metabolism and bone mineral density of lumbar spine (L1-4), trochanter femoris and femoral neck were compared between the two groups before treatment, three and six months after treatment. Independent-t test was used to compare the measurement data between two groups, and chi-square test was used for enumeration data. Paired-ttest and the repetitive measure analysis of variance for repeated measures were used to for intergroup compare. Results Compared with the results before treatment, the Harris score and Fernadez-esteve score of the observation group were higher than those of the control group after three and six months of treatment, (P <0.05), and the observation group was higher than the control group (P <0.05). Similarly, the levels of BGP, BALP, PICP, lumbar spine (L1-4), trochanter femoris and femoral neck bone mineral density in the two groups increased after six months of treatment (P <0.05), and the observation group was higher than the control group (P <0.05). Conclusion PTH combined with LFPEF can improve hip joint function, increase bone mineral density and promote fracture healing in elderly patients with intertrochanteric fracture after PFNA, which is worthy of clinical application. Key words: Parathyroid hormone; Hip fractures; Fracture fixation, intramedullary