Clinical Analysis Of Rapid Entry Point Pfna Internal Fixation In The Treatment Of A1-A2 Intertrochanteric Femur Fractures In The Elderly

Objective: To analyse the clinical efficacy of the PFNA technique for the treatment of A1-A2 intertrochanteric fractures in the elderly,and to provide a reference for the clinical treatment of A1-A2 intertrochanteric fractures in the elderly.Methods: A total of 100 patients with A1-A2 intertrochanteric fractures,all unilateral and aged over 60 years and less than 80 years,were selected from the Affiliated Hospital of Yanbian University between September 1,2020 and November17,2021 and treated surgically with PFNA technique under orthopaedic traction bed assisted repositioning,including 50 patients in the traditional positioning entry point group and 50 patients in the rapid positioning entry point group.50 patients were in the conventional approach point group and 50 patients in the rapid positioning approach point group.The general clinical data,operative time,intraoperative significant bleeding,intraoperative fluoroscopy of the pin point,postoperative fracture healing time,and the impact of the Harris Hip Function Score and ADL scale on the hip function and activities of daily living were compared between the two groups.The VAS score was applied for pain assessment both preoperatively and postoperatively(2 weeks,1 month,2 months,3 months and 6months).Results: A total of 100 patients were followed up for more than 6 months.The operative time was(37.60 ± 6.82)min for the patients in the traditional positioning site group and(28.70 ±3.64)min for the patients in the rapid positioning site group;the apparent intraoperative bleeding was(73.58±16.29)m L for the patients in the traditional positioning site group and(41.70±10.53)m L for the patients in the rapid positioning site group;the number of intraoperative fluoroscopic insertion points was(5.28±0.81)for the patients in the traditional positioning insertion point group and(2.34±0.66)for the patients in the rapid positioning insertion point group;the difference between the two groups was statistically significant(P<0.01).VAS scores for patients in the conventional positioning entry point group,preoperatively(8.24±0.71),2 weeks postoperatively(2.86±0.76),1 month postoperatively(2.66±0.72),2months postoperatively(1.58±0.70),3 months postoperatively(0.90±0.67)and6 months postoperatively(0.38±0.49);VAS scores for patients in the rapid positioning entry point group.preoperatively(8.10 ± 0.76),2 weeks postoperatively(2.46±0.61),1 month postoperatively(2.28±0.73),2 months postoperatively(1.30±0.54),3 months postoperatively(0.70±0.64)and 6 months postoperatively(0.32±0.47).Harris scores for patients in the conventional localized access point group,1 month postoperatively(50.96±7.66),2 months postoperatively(70.04±6.45),3 months postoperatively(80.96±3.10)and 6months postoperatively(93.86±2.88);Harris scores for patients in the rapid localized access point group,1 month postoperatively(55.14±7.52)and 2 months(73.20 ± 7.70),3 months postoperatively(82.58 ± 4.25)and 6 months postoperatively(94.28±0.40);ADL scale for patients in the conventionally positioned entry point group,1 month postoperatively(48.50±5.16),2 months postoperatively(65.90±5.77),3 months postoperatively(80.80±4.21)and 6months postoperatively(91.96±3.84);the ADL scale for patients in the rapid localisation entry point group was statistically significant at 1 month(51.20±4.58),2 months(68.50±4.87),3 months(80.10±3.82)and 6 months(90.20±3.77)postoperatively;the VAS scores were statistically significant when comparing the two groups at 2 weeks,1 month and 2 months postoperatively(P <0.05);Harris score at 1,2 and 3 months postoperatively was statistically significant(P < 0.05);ADL scale at 1 and 2 months postoperatively was statistically significant(P < 0.05).There was no statistically significant difference in the general perioperative data and postoperative fracture healing time between the two groups(P > 0.05).Conclusion: The fast and accurate entry point technique of PFNA is highly reproducible and can shorten the operation time,reduce surgical trauma,reduce the number of intraoperative fluoroscopy,reduce the amount of visible intraoperative bleeding,achieve rapid postoperative recovery,and is safe and reliable,which is worthy of clinical reference.