Factors Associated with Low Harris Scores Within 1 Year After PFNA-Ⅱ Surgery in Patients with Unstable Intertrochanteric Fractures
LI Yuhua
YANG Haifeng
MA Zikun
FENG Zipan
ZHAI Gongwei
Abstract：Objective To investigate the risk factors for low Harris scores in patients with unstable intertrochanteric fractures of the femur who underwent proximal femoral nail Asia type Ⅱ(PFNA-Ⅱ)fixation,and to analyze the relationship between low Harris scores and bone density,as well as bone metabolic indicators,within one year after surgery.Methods A retrospective study was conducted on 63 patients with unstable intertrochanteric fractures of the femur who were admitted to the Fifth Clinical Medical College of Henan University of Chinese Medicine(Zhengzhou People's Hospital)from February 2020 to February 2023.All patients underwent PFNA-Ⅱ internal fixation treatment.Clinical data at admission were collected,and their bone density and bone metabolic marker levels were recorded.Follow-up the patient for 1 year and record the Harris hip score at the end of the follow-up period.Twenty-two patients with Harris functional scores below 80 were included in the low Harris score group,while the remaining 41 patients were included in the high Harris score group.Data between the two groups was analyzed to investigate factors affecting patients' Harris scores.Results Higher levels of type Ⅰ collagen N terminal peptide,acid phosphatase 5 b in the low Harris score group than in the high Harris score group,the mean bone alponin and bone density was lower than the high Harris score group(P＜0.05).Through univariate and multivariate analysis,the American Society of Anesthesiologists(ASA)grade,mild osteoporosis,reduction quality,postoperative weight bearing time,fracture healing time,type Ⅰ collagen N-terminal peptide,tartarate acid phosphatase 5b,bone calponin,average bone mineral density would all affect the patients' Harris score 1 year after surgery,the relevant prediction model was established based on the results,and perform the verification,its area under the curve was 0.874,95％CI of 0.816-0.931,a sensitivity of 0.886,the specificity was 0.765,the optimal point-off at this time was 354.350.Conclusion The bone mineral density and bone metabolism level are significantly related with the occurrence of low Harris score within 1 year after the operation of unstable intertrochanteric fracture patients undergoing PFNA-Ⅱ,and the relevant risk prediction model has high predictive value.
Keywords：Asian intramedullary nailunstable intertrochanteric fractureHarris scorehip functionbone densitybone metabolism
Publication Date：2026-01-28
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：6( 245-250 )