Observation On The Early Clinical Effect Of TCM Boneset Manipulation Combined With PFNA In The Treatment Of Senile Intertrochanteric Fracture Of Femur

Objective: In this study,the effects of preoperative use of a group of traditional Chinese bone setting manipulations to release soft tissues and insert the fracture end on the clinical efficacy of closed reduction and PFNA internal fixation in the treatment of senile intertrochanteric fracture were investigated,and the mechanism of action was preliminaryly discussed.Methods: A total of 60 cases were included in this study.From January 2020 to December 2020,patients with intertrochanteric fracture of the femur(AO classification31A1.1--31A2)were selected according to the inclusion criteria for preoperative discussion and proposed to be treated with closed reduction and internal PFNA fixation.According to the order of admission and the random number table,they were randomly divided into control group and trial group.Both groups received closed reduction of intertrochanteric fracture with PFNA internal fixation,and traction bed was not used in both groups.In the control group,only intraoperative closed reduction was performed.In the experimental group,on the basis of the control group,after the patients were anesthetised and the muscle relaxants were fully applied,a group of traditional Chinese bone setting manipulations were added before disinfecting the affected limbs and laying the towel to release the soft tissues and insert the fracture end.The age,gender,the difference of neck stem Angle between the two groups after PFNA internal fixation,the varus rate of the hip joint,the flexion rate of the hip joint,the negative support rate of the posterior medial wall,and the Haris score of the hip joint at 2weeks,4 weeks and 3 months after the operation were recorded respectively.All the data were statistically analyzed using SPSS 20.0 software.Results: 1.There was no statistically significant difference in age,gender and other aspects between the two groups(P > 0.05).2.Compared with the control group,there was statistical significance in the varus rate of the experimental group(P < 0.05).3.The difference of hip neck stem Angle in experimental group was lower than that in control group,and the difference was statistically significant(P < 0.05).4.The negative support rate of posterior medial wall in experimental group was lower than control group,and the difference was statistically significant(P < 0.05).5.The hip joint anteroposterior inclination rate in experimental group was lower than that in control group,and the difference was statistically significant(P < 0.05).6.The Haris scores of the experimental group at 2 weeks,4 weeks and3 months after surgery were better than those of the control group with statistical significance(P < 0.05).Conclusion: 1.After the full effect of anesthetic muscle relaxant,a group of traditional Chinese medicine bonesetting techniques should be applied in advance before disinfectingthe affected limb and laying the towel,which can help to loosen the soft tissue and the insertion of the fracture end,and effectively improve the clinical efficacy of PFNA in the treatment of intertrochanteric fracture.2.Bone setting technique of traditional Chinese medicine is a cheap,convenient,safe and effective treatment method with no obvious side effects.