The effects of proximal femoral nail anti-rotation Ⅱ on the intraoperative conditions and blood loss volume in treatment of femoral intertrochanteric fractures in the elderly and clinical efficacy evaluation
Abstract：Objective To investigate the therapeutic effects of proximal femoral nail anti-rotation Ⅱ (PFNA-Ⅱ) on the intraoperative conditions and blood loss of the elderly patients in the treatment of femoral intertrochanteric fracture,and to evaluate its clinical efficacy.Methods According to different surgical methods,all the patients were divided into dynamic hip screw (DHS) group,locking proximal femoral plate (LPFP) group and PFNA-Ⅱ group,with 40 cases in each group.The intraoperative conditions (duration of operation,length of incision,the number of X-ray exposures),blood loss (pre-and post-operative hemoglobin levels and difference value,dominant blood loss,occult blood loss,and total blood loss) and Harris score were observed and compared.Moreover,the effects were evaluated based on Harris score.Results The duration of operation and incision length in PFNA-Ⅱ group were superior to those in DHS group and LPFP group,and the frequency of X-ray exposures was higher than that of DHS group and LPFP group,and the difference was statistically significant (P ＜ 0.05).The duration of operation was shorter and the frequency of X-ray exposure in LPFP group was significantly higher than that in DHS group (P ＜ 0.05).However there was no significant difference in the incision length between two groups (P ＞ 0.05).There were no significant differences in preoperative hemoglobin levels among the three groups (P ＞ 0.05),however,the postoperative hemoglobin levels in three groups were significantly lower than those before surgery (P ＜ 0.05).Moreover the postoperative hemoglobin levels in PFNA-Ⅱ group were higher than those in DHS group and LPFP group.The difference values,and amount of dominant blood loss,occult blood loss and total blood loss in PFNA-Ⅱ group were significantly lower than those in DHS group and LPFP group (P ＜ 0.05).The blood loss volume in LPFP group was significantly less than that in DHS group (P ＜ 0.05),whereas there were no significant differences in the other two indicators between the two groups (P ＞ 0.05).The Harris score and excellent rate in PFNA-Ⅱ group were significantly higher than those in DHS group and LPFP group at 1 and 3 months postoperatively (P ＜ 0.05).The therapeutic effects in PFNA-Ⅱ group at 1 month and 3 months after operation were better than those in DHS group and LPFP group (P ＜ 0.05),however,there were no significant differences between DHS group and LPFP group (P ＞ 0.05).Conclusion PFNA-Ⅱ used in treatment of intertrochanteric femoral fractures in the elderly can effectively reduce the operation time,incision length and intraoperative blood loss volume,which is helpful for postoperative recovery of patients and better recovery of hip joint function after operation.
Keywords：the elderlyintertrochanteric fracturesproximal femoral anti-rotational intramedullary Ⅱblood loss volumeHarris scoreeffect evaluation
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 1488-1491,1496 )