不同体位防旋股骨近端髓内钉与独活寄生汤在股骨粗隆间骨折中的应用OA

Objective To investigate the effect of proximal femoral nail antirotation(PFNA)with different positions combined with Duhuo Jisheng decoction in the treatment of patients with intertrochanteric femur fracture(IFF).Methods The clinical data of 120 patients with IFF from May 2021 to April 2024 were retrospectively analyzed,and they were divided into three groups by the differences of positions and treatment methods,with 40 cases in each group.The group A were treated with artificial traction in lateral position combined with PFNA,the group B were treated with orthopedic traction bed in supine position combined with PFNA,and the group C were treated with orthopedic traction bed in supine position,PFNA combined with Duhuo Jisheng decoction by oral after the operation.The operative indexes,fracture healing time,complications rates,Harris score at 1 year after operation,imaging indexes(tip-apex distance and difference in neck trunk angle with healthy side)at different time after the operation and bone turnover markers[Bone-specific alkaline phosphatase(BALP),Osteocalcin(OC)and β-C-terminal telopeptide of type Ⅰ collagen(β-CTX)]before and after the operation of two groups were compared.Results The hospitalization time and fracture healing time of group C were significantly shorter than those of group A and group B,the complications rate was significantly lower than that of group A and group B,Harris score at 1 year after operation were significantly better than those of group A and group B,the tip-apex distance and difference in neck trunk angle with healthy side at third,sixth and twelfth month after the operation were significantly smaller than those of group A and group B,the preoperative preparation time,operation time and intraoperative X-ray fluoroscopy time of group B and group C were significantly shorter than those of group A,the intraoperative blood loss were significantly less than those of group A(P<0.05),the incision length of three groups were compared,the differences were not statistically significant(P>0.05),the BALP and OC of group C at twelfth week after the operation were significantly higher than those of group A and group B,the β-CTX were significantly lower than those of group A and group B(P<0.05).Conclusion The effect of orthopedic traction bed in supine position,PFNA combined with Duhuo Jisheng decoction by oral after the operation in patients with IF was better,which is more helpful to the improvement of postoperative bone metabolism state and stability of patients.