Comparative Study Of Lengthened PFNA And Ordinary PFNA For Internal Fixation In Elderly Femoral Intertrochanteric Fracture

Objective:In view of the internal fixation of postoperative complications,especially the distal pain and internal fixation of distal femoral fractures,discuss the placement of internal fixation to test whether the length or depth of curative effect.Methods:A retrospective analysis into the analysis of standard and eliminated in conformity with the exclusion criteria,from Guangdong province Boluo county people's hospital of orthopedics in November 2010 to December 2015 were analyzed in 68 cases of elderly patients with femoral fracture,all cases were devided into lengthened PFNA group and ordinary PFNA group according to date of inpatient,between the rotor related:23 cases of male,female 45 cases;Aged 60 to 92 years,mean age(78.66±6.82);On the left side of the 36 cases,32 cases on the right side;Trauma:walk fall 20 cases,23 cases of traffic accidents,fall 10 cases,other injury15 cases;Merger of internal basic diseases,of which only 13 cases of hypertension,type only merge?9 cases,6 cases only with obvious osteoporosis,merger disease30 cases,10 cases without concurrent medical basic diseases.Fracture classification using Evans.According to the use of the spin of the proximal femoral intramedullary nailing(PFNA),the length of a range of different artificial divided subjects into lengthened PFNA group and ordinary PFNA group.Collect two groups of patients with intraoperative and postoperative conditions,statistical method is applied to the comparative analysis of two groups of patients with operation time,postoperative hospital stay,perioperative blood loss,fracture healing time,a year of knee joint function after operation,postoperative hip function,a year after a year of distal femur pain and the incidence of postoperative complications such as standard difference have statistical significance.Results:Two groups of general data and fracture classification is not statistically significant differences in the two groups data comparable;Perioperative blood loss of lengthened PFNA group was 842.1±88.9(ml)is greater than the ordinary PFNA group's777.3±78.7(ml),t=3.168,p=0.002,p<0.05,the difference is statistically significant;Long operation time was 90.3±12.1(min)is greater than81.8±10.9(min)and ordinary PFNA group,t=3.024,p=0.004,p<0.05,the difference is statistically significant;lengthened PFNA group,length of hospital stay was 10.3±2.2(day),the ordinary PFNA group was 9.6±2.5(day),t=1.193,p=0.237,p>0.05,no statistically significant difference;lengthened PFNA group,fracture healing time was 95.3±20.2(day)and ordinary PFNA group was 99.6±19.5(day),t=-0.882,P=0.381,P>0.05,no statistically significant difference;Two groups of patients with postoperative year of knee joint function,lengthened PFNA group of HSS score(86.5±9.4)and the fine rate(85.7%)and ordinary PFNA group score(84.9±10.6)and the fine rate(80.0%),grade t=0.641,P=0.524>0.05,the excellent?~2=0.555,P=0.907>0.05,there was no statistically significant difference;Two groups of patients with postoperative hip function of year,lengthened PFNA group Harris scoring(85.5±10.4)and the fine rate(85.7%)and ordinary PFNA group score(82.2±10.1)and the fine rate(80.0%),grade t=1.310 P=0.195>0.05,the excellent,?~2=0.398,P=0.941>0.05,there was no statistically significant difference;Two groups of patients with postoperative year of distal femur pain condition,compare the stretched group of NRS score(0.7±0.2)and ordinary PFNA group of NRS score(2.2±0.7),t=-11.007,P=0.000,P<0.05,the difference was statistically significant.A comparison to the score of the two groups,?~2=7.9,P=0.048,P<0.05,the difference was statistically significant;lengthened PFNA group and ordinary PFNA group total rate of postoperative complications is don't is 32.1%and 40.0%,more complications,?~2=5.582,P=0.349,P>0.05,there was no statistically significant difference.But the lengthened PFNA group,the incidence of postoperative femoral distal secondary fracture(3.6%)are much smaller than ordinary PFNA group(20%),?~2=3.871,P=0.049,P<0.05,the difference was statistically significant.Conclusion:the two kinds of length of PFNA is the treatment of senile femoral fracture between the rotor is very reliable treatments,and each have advantages and disadvantages.In perioperative blood loss,operating time and average length of PFNA is more outstanding,help reduce body and family burden of elderly patients.Although the difference between the two groups in terms of overall postoperative complications incidence is not big,but in the distal femur pain and distal femur secondary fractures,application of long PFNA treatment has the edge,is beneficial to improve the quality of life in patients with,avoid reoperation,worthy of promotion.