Bin Wang1, Qingbai Liu2, Yu Liu3, Rui Jiang2. 1. Department of Orthopedics, The Second Affiliated Hospital of Xuzhou Medical University, 221006, China. 2. Department of Orthopedics, Lianshui County People's Hospital, Huai'an, 223400, China. 3. Department of Orthopedics, Wuxi Orthopaedic Hospital, 214062, China.
Abstract
OBJECTIVE: To compare effect of proximal femoral nail antirotation (PFNA) and dynamic hip screw (DHS) internal fixation on serum inflammatory mediators (CRP, IL-1, IL-6 and TNF-α), myocardial injury markers (cTnT, CK-MB), and Myo-heart failure marker (BNP) in elderly patients with intertrochanteric fractures. STUDY DESIGN: Experimental study. PLACE AND DURATION OF STUDY: Department of Orthopedics, The Second Affiliated Hospital of Xuzhou Medical University, China, from January 2016 to February 2018. METHODOLOGY: A total of 114 patients with intertrochanteric fractures were randomly divided into Group A and Group B, with 57 cases in each group. Group A was treated with PFNA and Group B with DHS internal fixation. Serum CRP, IL-1, IL-6, TNF-α, cTnT, CK-MB, Myo, BNP and surgical indication were compared. RESULTS:Operation time and weight-bearing time in Group A were shorter than Group B (both p<0.001). Intraoperative blood loss and postoperative drainage volume in Group A were lower than Group B (both p<0.001). On the 7ᵗʰ day after surgery, serum CRP, IL-1, IL-6, TNF-α, cTnT, CK-MB, Myo and BNP in Group A were lower than Group B (all p<0.001). CONCLUSION: Compared with DHS, PFNA effectively reduced serum inflammatory mediators with less damage to cardiac function and myocardium in elderly patients with intertrochanteric fractures.
RCT Entities:
OBJECTIVE: To compare effect of proximal femoral nail antirotation (PFNA) and dynamic hip screw (DHS) internal fixation on serum inflammatory mediators (CRP, IL-1, IL-6 and TNF-α), myocardial injury markers (cTnT, CK-MB), and Myo-heart failure marker (BNP) in elderly patients with intertrochanteric fractures. STUDY DESIGN: Experimental study. PLACE AND DURATION OF STUDY: Department of Orthopedics, The Second Affiliated Hospital of Xuzhou Medical University, China, from January 2016 to February 2018. METHODOLOGY: A total of 114 patients with intertrochanteric fractures were randomly divided into Group A and Group B, with 57 cases in each group. Group A was treated with PFNA and Group B with DHS internal fixation. Serum CRP, IL-1, IL-6, TNF-α, cTnT, CK-MB, Myo, BNP and surgical indication were compared. RESULTS: Operation time and weight-bearing time in Group A were shorter than Group B (both p<0.001). Intraoperative blood loss and postoperative drainage volume in Group A were lower than Group B (both p<0.001). On the 7ᵗʰ day after surgery, serum CRP, IL-1, IL-6, TNF-α, cTnT, CK-MB, Myo and BNP in Group A were lower than Group B (all p<0.001). CONCLUSION: Compared with DHS, PFNA effectively reduced serum inflammatory mediators with less damage to cardiac function and myocardium in elderly patients with intertrochanteric fractures.
Authors: Sharon R Lewis; Richard Macey; Joseph Lewis; Jamie Stokes; James R Gill; Jonathan A Cook; William Gp Eardley; Martyn J Parker; Xavier L Griffin Journal: Cochrane Database Syst Rev Date: 2022-02-10