The Study Of Elderly Femoral Fractures Between PFNA Reset After The Analysis Of The Causes Of Missing

ObjectiveExplorethe elderly femoral fracture PFNA reset the lost risk factors between the rotor and predict the loss of a reset after may, to guide the further functional exercise, reduce the risk of internal fixation of postoperative failures.MethodsRetrospective analysis from January 2010 to December 2014 were 86 cases of senile femoral fractures in patients with clinical data, between the rotor (37 male and female 49 cases;Age 60-94. With Baumgaertner reduction and quality evaluation of postoperative 1 week compared with postoperative 12 weeks ago after the two results to judge the standard of the reduction and loss level. Reset lost group of 27 cases (31.4%), a reduction and loss of group 59 patients (68.6%). Collect the basic information of the patients, fracture type, Singh index, preoperative ASA rating, TAD 1 week after operation, postoperative 1 week after reduction and quality, after 12 weeks of reset quality and reset the medial femoral bone block small rotor displacement, etc. Using Logistic regression analysis to determine the femur fracture PFNA reset between rotor loss risk factors. Before and after the statistics and oblique X-ray spiral blade location distribution and to analyze its relationship with reset lost.ResultReset lost with the reset lost group to compare the clinical baseline data comparison, found that the fracture types chi-square=9.276, P=0.026<0.05, suggesting that fracture between various types share differences between two groups was statistically significant;Postoperative 1 week TAD index u=-4.867, P=0.000<0.01, suggesting that postoperative 1 week TAD differences between two groups was statistically significant. Postoperative week reset quality chi-square=11.216, P=0.001<0.01, suggesting that a week between the two groups of postoperative restoration quality proportion difference was statistically significant. The rest of the P value for each index were greater than 0.05, suggesting there was no statistically significant difference. Logistic single factor analysis, fracture type, TAD a week after operation, postoperative 1 week reset three quality indexes of the P value is less than 0.05, shows three indicators and reset the statistically significant correlation between lost;After sex, age, medial femoral bone block small rotor displacement, Singh index, preoperative ASA score five indicators of P values were greater than 0.05, shows that the four indexes and the relationship between the reduction and loss of no statistical significance. Logistic multifactor regression analysis report, quality of postoperative 1 week TAD, 1 week after reset to reset the lost statistically significant (P<0.05), postoperative 1 week of TAD OR=0.239, shows that TAD> 2.5 cm were more likely to lead to reset lost, is a TAD> 2.5 cm cause a reduction and loss of 4.1 times;Postoperative 1 week reset quality OR=0.269, reset is reset lost when the quality as the optimal protection factors, shows that reduction and quality as the "poor" leads to reset the loss reduction and quality as the "best" is the danger of 3.7 times. Fracture type index of P value is greater than 0.05, we think in multiple factors analysis, the impact on the reduction and loss of no statistical significance. Results:the spiral blades in the femoral head in area on the lateral slice, reset lost group center a 21 cases (77.8%), a reduction and loss of group center a 52 cases (88.1%);Group is slice, reset lost center a 21 cases (77.8%), a reduction and loss of group centre,16 cases (27.1%), eccentric a reduction and loss of group 6 cases (22.2%), the eccentric a reduction and loss of group 43 cases (72.9%).DiscussionIntraoperative reduction and quality according to the Baumgaertner standard level for more than a good, at least after femoral medial cortical bone block to shift within 5 mm can not importune anatomical repositioning, spiral blade spire from TAD value within the 25 mm, reasonable area in BC, nailing spiral blade tip area is located in no.1 and 4.Type for unstable fracture type (Ic, Id) and severe osteoporosis patients, surgeons should be more strict requirements to ensure the quality of surgery, postoperative active prevention and treatment of osteoporosis, in order to reduce the occurrence of postoperative reset the risk of loss coefficient.