Non-Traction Table Reduction Combined With PFNA In Older People Clinical Study Of Intertrochanteric Fractures Of The Femur

Objective:To compare the effects of traction table reduction and non-traction table reduction combined with PFNA internal fixation in the treatment of elderly intertrochanteric fractures.Method:1.Elderly patients with intertrochanteric femoral fracture admitted to the Department of Orthopedics and Traumatology of the Affiliated Hospital of Jiangxi University of Chinese Medicine from June2021 to October 2022 were selected,and a total of 40 patients were included as the study subjects according to the inclusion and exclusion criteria,and the patients were divided into traction table group and non-traction table group according to different fracture reduction methods,with 20 patients in each group.There were 8 males and 12 females in the traction table group.The age was 60-100 years,and the average age was 80.95±9.45 years;Height 153-175 cm,average height 162.40±6.10cm;The weight is 47-73 kg,and the average weight is 57.15±7.80 kg.The fracture types were Evans-Jensen III.1,Evans-Jensen IV.7,and Evans-Jensen V.12.There were 7 males and 13 females in the non-traction table group.The age was 63-92 years,and the average age was 80.55±7.06 years;Height 153-170 cm,average height 160.75±5.54cm;The weight is 46-74 kg,and the average weight is 56.65±8.00 kg.The fracture types were Evans-Jensen type III.in 1 case,Evans-Jensen type IV.in 9 cases,and Evans-Jensen type V in 10 cases.2.All patients included in the study have improved preoperative related imaging examinations and blood tests,adjusted the physical state of patients before surgery,informed their families and patients of their surgical treatment plan,surgery-related risks and the content of this study after there are no obvious contraindications to surgery,and signed the relevant informed consent form after obtaining the consent of the patient and his guardian.Patients in the traction table group used traction table to reduce the fracture,and the non-traction table group used traditional Chinese medicine orthopedic manipulation to reduce the fracture,if the broken end was unstable after reduction,Kirschner needle could be used for temporary fixation,and the rest of the surgical operations received by the two groups were consistent.Postoperative follow-up was followed up according to the requirements of the project,and data such as the length of surgical incision,intraoperative blood loss,number of fluoroscopy,length of preoperative preparation,duration of surgery,duration of anesthesia,fracture healing time,VAS score of 1 day and 7 days before surgery,and Harris score of the affected hip 3 to 6 months after surgery were collected.3.Organize and summarize the relevant data collected by this research project,use the statistical software SPSS 25.0 to process the relevant data,analyze and finally draw the conclusions of this research project according to the statistical results obtained.Result:Both groups successfully completed surgery and followed up to6 months after surgery,and there was no significant difference in general data and fracture type distribution between the two groups(P>0.05).In terms of preoperative preparation time and anesthesia time,the data of traction table group were significantly higher,and the difference between the two groups was statistically significant(P<0.001).In terms of the number of perspectives,the data of the traction table group were significantly lower,and the difference between the two groups was statistically significant(P <0.001).In terms of VAS score at 1 day after surgery,the non-traction table group was significantly lower,and the difference between the two groups was statistically significant(P<0.001).There was no significant difference between the two groups in terms of intraoperative blood loss,fracture healing time,operation duration,surgical incision length,VAS score before and 7 days after surgery,Harris score at 3 and 6 months postoperative,postoperative complications,and clinical efficacy at 6 months after surgery(P>0.05).Conclusion:1.Two different reduction methods combined with PFNA internal fixation have good efficacy in elderly patients with IFF.2.The non-traction table group was lower than the traction table group in terms of preoperative preparation time,anesthesia time and early postoperative pain,but higher than the traction table group in terms of the number of fluoroscopy.3.Non-traction table reduction combined with PFNA internal fixation in the treatment of elderly IFF is simple,convenient and has clear efficacy,which is worth promoting in hospitals that lack traction tables or have relatively lack traction table resources.