Clinical Effect's Analysis Of PFNA Combined With Lateral Wall Reconstruction In The Treatment Of Femoral Intertrochanteric Fracture With Lateral Wall Injury

Objective:To study and analyze the effect of PFNA combined with lateral wall reconstruction in the treatment of femoral intertrochanteric fracture with lateral wall injury.(1)Analyze the effect of PFNA combined with lateral wall reconstruction in the treatment of femoral intertrochanteric fracture with lateral wall injury.(2)Improvement and re-evaluation of PFNA treatment techniques.(3)Re-understanding of the indication standards of PFNA surgical treatment.Methods:The clinical data of 30 intertrochanteric femoral patients with lateral wall injuries admitted to our hospital from December 2017 to December 2018 were analyzed retrospectively.Among them,19 were male and 11 were female.The average age was between 65 and 85 years old.The patients were randomly divided into two groups:A and B.The patients in group A were treated with PFNA alone,including 9 males and 6 females.Group B was treated with lateral wall reconstruction combined with PFNA,including 10 males and 5 females.Harris hip score was used to evaluate the healing effect of fracture healing.The length of incision,time consumed,intraoperative bleeding and the number of complications were compared between the two groups.Result:Both groups were followed up for an average of 8.39+2.32 months.No incision infection and deep venous thrombosis of lower extremities occurred.All patients met the criteria of bone healing.There were no complications such as coxa varus,anti-rotation screw removal and internal fixation loosening failure in both groups.Because of the different complexity of different surgical methods,the length of incision,operation time and intraoperative bleeding in group B increased compared with group A,and the degree of trauma was more serious than that in group A.However,the time for fracture to reach the standard of bone healing and the speed of functional recovery after operation were better than those in group A.According to Harris hip score criteria,group A had 8 excellent cases,5 good cases,2 fair cases,the excellent and good rate was 86.67%.Group B had 11 excellent cases,3 good cases and 1 fair case,the excellent and good rate was 93.33%.Conclusion:For intertrochanteric fractures with injury to the lateral wall of the femur,a more stable and reliable internal fixation can be provided on the basis of the(PFNA)procedure of the proximal femoral anti-circumflex intramedullary nail,combined with the repair and reconstruction of the lateral femoral wall.Strengthen the clinical treatment effect,alleviate the pain of the patient,accelerate the speed of fracture healing,improve the stability of the fracture after operation,so that the patients can begin the exercise of weight-bearing function as soon as possible,restore their movement ability,and effectively reduce the occurrence of postoperative complications.Solved the clinical problems that treatment of intertrochanteric fractures with injury of lateral wall of femur by using proximal femoral anti-circumflex intramedullary nail alone at present is prone to failure of internal fixation.