Biomechanical properties in patients with intertrochanteric fracture treated with proximal femoral nail internal fixation(PDF)
《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]
- Issue:
- 2019年第8期
- Page:
- 989-994
- Research Field:
- 生物材料与力学
- Publishing date:
Info
- Title:
- Biomechanical properties in patients with intertrochanteric fracture treated with proximal femoral nail internal fixation
- Author(s):
- HE Miao; DENG Zhilong; CAO Zhidong; LIU Jian; ZHANG Xiaoxing
- Department of Orthopedics, Chongqing Emergency Medical Center, Chongqing 400014, China
- Keywords:
- ; Keywords: intertrochanteric fracture; biomechanics; proximal femoral nail internal fixation; artificial hip replacement
- PACS:
- R68；R318.01
- DOI:
- DOI:10.3969/j.issn.1005-202X.2019.08.024
- Abstract:
- Abstract: Objective To investigate the effect of proximal femoral nail (PFNA) internal fixation on the biomechanical properties in patients with intertrochanteric fracture. Methods A total of 132 patients with intertrochanteric fracture who were admitted to Chongqing Emergency Medical Center from June 2015 to June 2017 were enrolled in the study and then divided into group A (n=66) and group B (n=66) according to the surgical procedure. PFNA internal fixation was adopted in group A, while artificial hip replacement was conducted in group B. The perioperative indicators of the two groups were compared, including operation time, intraoperative blood loss, bed rest time, postoperative drainage, hospitalization time and fracture healing time. Harris score was used to evaluate the recovery of joint functions in two groups before and at 6 months and 12 months after operation. Biomechanical properties, including the torsional stiffness and torque at 1.5° torsion as well as the compressive stiffness and displacement at 800 N load, were compared between two groups at 6 months and 12 months after operation. The incidences of complications in two groups were also recorded. Results The amount of intraoperative blood loss in group A was less than that in group B, and the operation time, bed rest time, hospitalization time and fracture healing time in group A were shorter than those in group B (P<0.05). Harris scores at 6 months and 12 months after operation in both groups were higher than those before operation, and Harris scores in group A at 6 months after operation were higher than those in group B (P<0.05). The torsional stiffness and torque at 1.5° torsion and the compressive stiffness at 800 N load in both two groups at 12 months after operation were higher than those at 6 months after operation, and the compressive displacement at 800 N load was smaller than that at 6 months after operation. At 6 months after operation, the torsional stiffness and torque at 1.5° torsion and the compressive stiffness at 800 N load in group A were higher than those in group B, and the compressive displacement at 800 N load was smaller than that in group B, with statistical significance (P<0.05). No statistical significance was found in the incidence of complications which was 6.06% and 9.09% in group A and B, respectively (P>0.05). Conclusion Compared with artificial hip replacement, PFNA internal fixation for intertrochanteric fracture has higher clinical value for it can achieve more significant therapeutic outcomes, further promote the recovery of postoperative body function and improve the biomechanical properties at 6 months after surgery, without increasing the risk of complications.
Last Update: 2019-08-27