Effects of closed reduction proximal femoral nail antirotation internal fixation on the fracture healing and life quality of patients with femoral trochanteric fracture

doi:10.3969/j.issn.1002-7386.2018.01.017

Abstract：Objective To investigate the effects of closed reduction proximal femoral nail antirotation (PFNA) internal fixation on the fracture healing and life quality of patients with femoral trochanteric fracture.Methods A total of 200 patients with femoral trochanteric fracture who were admitted and treated in our hospital from December 2010 to December 2016 were randomly divided into closed reduction group (n =100) and open reduction group (n =100).All the patients were treated by PFNA internal fixation,in addition,the patients in open reduction group were treated by open reduction,however,the patients in closed reduction group were treated by closed reduction,in which,according to closed reduction methods,the patients were redivided into traditional closed reduction group and improved closed reduction group,with 50 patients in each group.The patients in traditional closed reduction group were treated by traditional manual traction closed reduction,however,the patients in improved closed reduction group were treated by improved minimally invasive prying closed reduction.After treatment,the hip joint function of patients was assessed by Harris hip function criteria (Harris),and patient's life quality was evaluated by daily life ability scale (ADL),with 12-month followe up.The curative effects,intraoperative bleeding volume,weight-bearing functional exercise,length of staying in hospitalization,fracture healing time,complications and Hip joint function before and after treatment,the life quality before treatment and on 3m,12m after treatment were statistically analyzed.Results The intraoperative bleeding volume,length of staying in hospital,incidence rates of traumatic complications in traditional closed reduction group and improved closed reduction group were significantly lower than those in open reduction group (P ＜ O.05),however,there were no significant differences in these indexes between traditional closed reduction group and improved closed reduction group (P ＞ 0.05).The weight-bearing functional exercise,fracture healing time,incidence rates of healing complications in open reduction group and improved closed reduction group were significantly lower than those in traditional closed reduction group (P ＜ 0.05),but there were no significant differences in these indexes between open reduction group and improved closed reduction group (P ＞ 0.05).Moreover there were no significant differences in the excellent and good rates of therapeutic effects after 3-month treatmen,ADL scores and Harris scores among open reduction group,traditional closed reduction group,improved closed reduction group (P ＞ 0.05),however,the the excellent and good rates of therapeutic effects after treatmen,ADL scores and Harris scores after 12-month treatmen in open reduction group and improved closed reduction group were significantly higher than those in traditional closed reduction group (P ＜ 0.05),furthermore,there were no significant differences in the excellent and good rates of therapeutic effects after 12-month treatmen,ADL scores and Harris scores between open reduction group and improved closed reduction group (P ＞ 0.05).Conclusion The closed reduction PFNA internal fixation in treatment of femoral trochanteric fracture can effectively decrease intraoperative trauma and incidence of traumatic complications,without adverse effects on short-term curative effects and life quality of patients,but traditional manual traction closed reduction may decrease fracture healing effects,long-term curative effects and life quality,however,the improved minimally invasive prying closed reduction can effectively avoid these shortcomings,therefor,which is worth using widely in clinical practice.