Experience Of PFNA In Treating 56 Cases Of Senile

The main purpose of this study was to investigate the therapeutic effect of proximal femoral anti-rotation intramedullary nail(PFNA)in elderly intertrochanteric fractures,as well as the main complications and preventive measures in the course of diagnosis and treatment.To provide theoretical basis for clinicians to formulate comprehensive and reasonable treatment plan according to different conditions in perioperative period,to guide patients to exercise reasonably after operation,and to obtain the best therapeutic effect.56 patients(age > 60)with intertrochanteric fracture of femur treated with PFNA internal fixation were collected from June 2016 to June 2017 in the Orthopaedics Department of the first affiliated Hospital of Hebei North University.There were 22 males and 34 females,aged 60 to97 years,with an average age of 70 years.The amount of blood lost during the operation,the time used for the operation,and the time required for the operation were recorded,and the healing time of the fracture was recorded by regular reexamination or telephone follow-up for 18 months.The complications and the Harris score of hip function were measured respectively in the first and last time after operation.The statistical results showed that the operative time was 50 ~ 150 min(mean 80 min),and the operative time was 80 min.No internal fixation fracture occurred;and Complications such as femoral shaft fracture.Intraoperative bleeding was50 ~ 140 ml(mean,90 ml).After internal fixation,all the wounds healed at the first stage without incision infection.All the 56 patients with effusion were followed up for 12 ~ 18 months.The average was 14 months.During the follow-up period,the TAD values measured at the first and last times after operation were statistically analyzed,P > 0.05.There was no statistical significance,which indicated that the control intensity of the helical blades locked in the neck of the femoral head was large.The controleffect was stable.According to the X-ray findings taken at the time of reexamination,all fractures were found.The healing time was 10 ~ 17 weeks and the average healing time was 15 weeks.According to the Harris score of hip joint function at the last follow-up,the functional recovery was excellent in 45 cases,good in 6 cases,fair in 5 cases.The excellent and good rate was 91.07%.The effect of PFNA treatment was positive.Only a few of the patients had complications: one elderly male patient developed thrombus in the lower extremities on the 8th day after operation during hospitalization,and the thrombolytic therapy was given to ICU and cardiology in time because of partial thromboembolism of the patient.A case of elderly during follow-up After January,female patients fell down carelessly when they left the bed and fell down.The fracture of distal femoral shaft was treated with lower extremity traction and conservative treatment for 4 months,and 3 patients suffered from proximal thigh pain.Considering the excessive stimulation of the tail cap of the internal fixator or the excessive compression of the lateral cortex of the proximal end of the femoral shaft outside the entry point of the main nail,the treatment of oral non-steroidal analgesic drugs has improved.In conclusion,the anti-rotation blade at the proximal end of PFNA has a high holding strength.The fixation of the fracture end is firm,and the central fixation arm of the PFNA nail is shorter.The intramedullary fixation device,as represented by the PFNA nail,has obvious biomechanical properties.PFNA is an effective treatment even in elderly patients with significant decrease in bone mineral density.Firm fixation,less complications and remarkable recovery of postoperative function have become one of the most widely used fixation methods.