Association between hip fracture fixation methods and bone mineral density T-value in middle-aged and elderly patients with hip fractures.

Abstract

Objective: To examine the association of proximal femoral nail anti-rotation (PFNA) and dynamic hip screw (DHS) with bone mineral density T-value (BMDT) in middle-aged and elderly patients suffering from hip fractures.

Methods: Clinical data were collected from 110 patients with hip fractures who underwent internal fixation surgery between October 2020 and June 2021. Patients treated with DHS were included in the control group, and those treated with PFNA were classified into the observation group. The disparity in BMDT between the two groups was assessed. Patients were further divided into two groups based on the median BMDT at 6 months post-surgery: a high BMDT group (BMDT>-1.1 SD) and a low BMDT group (BMDT≤-1.1 SD). Factors influencing BMDT were analyzed.

Results: Repeated measures ANOVA showed that BMDT in the observation group was higher than that in the control group at 7 days, 1 month, 3 months, and 6 months after the surgery (between-group effect: F=258.400, P<0.001). BMDT in both groups increased with time but remained lower than pre-surgery levels (time effect: F=28.760, P<0.001), with an interaction between group and time (F=6.478, P<0.05). Correlation analysis showed a significant correlation between internal fixation techniques and BMDT at 7 days, 1 month, 3 months, 6 months after the surgery (P<0.05). Logistic regression analysis showed that advanced age and a higher VAS score at 72 hours post-surgery were risk factors for low BMDT at 6 months post-surgery, while PFNA was a protective factor (all P<0.05).

Conclusion: Compared to DHS, PFNA significantly improves BMDT in middle-aged and elderly patients following hip fracture surgery, promoting better early-stage recovery. PFNA should be prioritized in clinical practice to enhance postoperative outcomes.