外侧壁破裂型股骨粗隆间骨折行钢板辅助外侧壁重建联合加长InterTan髓内钉固定治疗的效果OA

Objective:To explore the clinical effect of steel plate assisted lateral wall reconstruction combined with lengthened InterTan intramedullary nail fixation in the treatment of lateral wall rupture type femoral intertrochanteric fractures.Methods:A retrospective analyzed was made of the data of 63 patients with lateral wall rupture type femoral intertrochanteric fractures admitted to the Jinan Seventh People's Hospital from March 2023 to March 2024.They were divided into an intramedullary nail group(n=31)and a combined group(n=32)according to different treatment methods.The intramedullary nail group was treated with lengthened InterTan intramedullary nail fixation,while the combined group was treated with steel plate assisted lateral wall reconstruction combined with lengthened InterTan intramedullary nail fixation.The surgical trauma and postoperative recovery indicators,hip joint function,hip joint range of motion and the occurrence of complications were compared between the two groups.Results:The surgical blood loss and postoperative drainage volume in the combined group were greater than those in the intramedullary nail group,the operation time was longer than that in the intramedullary nail group,the number of intraoperative fluoroscopy sessions was more than that in the intramedullary nail group,the fracture healing time was shorter than that in the intramedullary nail group,the differences were statistically significant(P<0.05).Three months after surgery,the scores of pain degree,joint functional activity,joint range of motion and total score in the Harris Hip Scale of the combined group were higher than those in the intramedullary nail group,the differences were statistically significant(P<0.05);Six months after surgery,the scores of joint function activity,joint range of motion and total score in the Harris Hip Scale of the combined group were higher than those in the intramedullary nail group,the differences were statistically significant(P<0.05).Three months after surgery,the hip flexion and degree in the combined group was greater than that in the intramedullary nail group,the difference was statistically significant(P<0.05);Six months after surgery,there were no statistically significant differences in the degrees of hip flexion,abduction and adduction extension,external and internal rotation between the two groups(P>0.05).The incidence of complications of the combined group was 9.38%,which was not statistically significant compared with 16.13%in the intramedullary nail group(P>0.05).Conclusion:The treatment of lateral wall rupture type femoral intertrochanteric fractures with steel plate assisted lateral wall reconstruction combined with lengthened InterTan intramedullary nail fixation than the treatment with lengthened InterTan intramedullary nail alone,can better promote the recovery of joint function,improve hip joint mobility,and has certain safety.