Effect Of Proximal Femoral Plate In The Treatment Of External Wall Incomplete Or Comminuted Intertrochanteric Fracture

Objective:To evaluate the clinical effect of proximal femoral locking plate(PFP)surgery in the treatment of patients with incomplete lateral wall or comminuted intertrochanteric fractures of the femur,summarize the experience and shortcomings,in order to provide theoretical basis and data support for the treatment of this type of fracture with PFP in the future.Methods : A retrospective study was performed to evaluate the clinical outcomes of 44 patients with intertrochanteric fracture treated by internal fixation with PFP from July 2019 to July 2022 at the Department of trauma orthopedics in our hospital.A total of 38 patients with intertrochanteric femoral fracture treated by PFNA at the same time period in our department were also used as the control group.The perioperative evaluation indexes,such as operative time,intraoperative blood loss,postoperative drainage volume,intraoperative fluoroscopy number and hospital days,as well as the follow-up criteria,such as fracture healing time,postoperative complication rate,surgical healing rate and Harris score,of the two groups were statistically analyzed,and the efficacy of the proximal femoral locking plate for the treatment of incomplete or comminuted intertrochanteric femoral fractures with lateral walls was comprehensively evaluated.Results: The operation of both groups of inpatients was successfully completed.The operation time,intraoperative blood loss,postoperative drainage flow and hospitalization days of patients in the PFP group were significantly greater than that of the PFNA group.The difference was statistically significant(P<0.05).The intraoperative blood loss,postoperative drainage flow and total dominant blood loss were greater than that of the PFNA group.The difference was statistically significant(P<0.05).The invisible blood loss,total blood loss and intraoperative fluoroscopy in the PFNA group were greater than that in the PFP group,and the difference was statistically significant(P<0.05).There was no significant difference in the postoperative cure rate,fracture healing time and postoperative complications between the two groups,and there was no statistical significance.The PFP group had a better score than the PFNA group in the Harris score in March and June after surgery.The difference was statistically significant(P<0.05).There was no significant difference between the scores of the two groups in December after surgery,and the difference was not statistically significant.Conclusio;Proximal femoral locking plate and proximal femoral anti-rotary intramedullary nails are feasible methods for the treatment of femoral intertrochanteric fractures.For lateral wall incomplete or comminuted femoral intertrochanteric fractures,PFP has a good therapeutic effect.PFP has relatively few perspectives during operation,fewer complications,and high fracture healing rate,which is conducive to rehabilitation.Satisfactory clinical results can be obtained in the treatment of lateral wall imperfect or comminuted intertrochantral femoral fractures,which has certain clinical value.