Effect of proximal femoral anti-rotation nail internal fixation on femoral intertrochanteric fracture in elderly patients

Abstract

Objective To study the clinical effect of proximal femoral anti-rotation nail internal fixation on femoral intertrochanteric fracture in elderly patients, and study its effect on the activity of femoral joint. Methods Eighty elderly patients with intertrochanteric fracture hospitalized in the Eighty-eighth Hospital of the People’s Liberation Army from January 2015 to August 2017 were selected as research objects. And they were divided into control group and observation group according to the random number table method, with 40 cases in each group. Patients in control group were treated by proximal femoral anti-rotation nail internal fixation and patients in observation group were treated by dynamic hip screw . The clinical curative effect, surgical condition, postoperative recovery, postoperative pain score and recovery of hip function were compared between the two groups. Results The total effective rate of observation group was 95.00%, which was higher than 80.0% of control group (P<0.05). The operative time and the intraoperative bleeding volume of observation group was (84.71 ±7.29) min and (265.46 ±44.87)ml, respectively, which were better than (95.36 ±10.35) min and (327.12 ±59.18) ml of control group (P<0.05). Postoperative recovery, the time of movement out of bed, hospital stay and fracture healing time in observation group were (4.19 ±1.25)d, (6.39 ±1.84)d and (13.64 ±3.17)weeks, respectively, which were shorter than those in control group, (5.72±1.68)d, (8.56 ±2.17) d and (18.37 ±4.29) weeks, P<0.05. The pain scores of observation group at 8 hours, 12 hours, 24 hours and 48 hours after operation were 3.46 ±0.97, 2.96 ±0.95, 2.67 ±1.02 and 2.56 ±0.94, respectively; all the scores were lower than those of control group (4.52 ±1.08, 4.07 ±1.14, 3.82 ±1.18 and 3.65 ±1.09), P<0.05. The excellent and good recovery rate of the hip motion function in observation group was 92.50%, which was higher than that in control group (75.0%), P<0.05; and the hip function score in observation group (84.75 ±10.28) was higher than that in control group (73.21 ±9.93), P<0.05. Conclusions Proximal femoral anti-rotation nail internal fixation in the treatment of elderly patients with intertrochanteric fracture of femur can effectively improve the clinical effect, reduce the postoperative pain and trauma, and promote the recovery of hip joint function after operation. Key words: Advanced age; Intertrochanteric fracture of femur; Internal fixation; Proximal femoral anti-rotation internal nail