Effect of denosumab combination with proximal femoral nail antirotation surgery in elderly patients with intertrochanteric femoral fractures: A comparative study

IF 2.6 Q3 ENDOCRINOLOGY & METABOLISM

Bone Reports Pub Date : 2025-07-28 DOI:10.1016/j.bonr.2025.101860

Xiaoqing Lu, Jun Zhu, Bai Zheng, Junsheng Wang

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Abstract

Objective

To evaluate the effect of denosumab combined with proximal femoral nail antirotation (PFNA) surgery in elderly patients with osteoporotic intertrochanteric femoral fractures (ITF Fx).

Design and Setting

This retrospective, comparative study included patients aged ≥65 years with osteoporotic ITF Fx who underwent PFNA fixation at Huai'an Second People's Hospital between July 2021 and July 2023.

Participants

Pain relief (visual analogue scale, VAS), hip function, bone mineral density (BMD), time to fracture healing, refracture rate, and adverse events were compared.

Interventions

This is a retrospective study, without the addition of any intervention measures.

Results

A total of 76 patients were included, with 38 patients in the denosumab + PFNA group and 38 in the PFNA group. The denosumab + PFNA group showed significantly greater improvements in pain relief (1.68 ± 0.93 vs 2.29 ± 0.97, p = 0.014) and BMD T-score (−1.49 ± 0.61 vs −1.98 ± 0.52, p = 0.006) at 12 months compared to the PFNA group. Fracture healing time was significantly shorter in the denosumab + PFNA group (12.37 ± 1.38 vs 13.63 ± 1.34 weeks, p < 0.001), and the refracture rate was significantly lower (2.63 % vs 21.05 %, p < 0.05) than that in the PFNA group. The post-treatment hip function was comparable between the denosumab + PFNA and PFNA groups. Only one case of hypocalcemia was reported in the denosumab + PFNA group (2.63 %).

Conclusion

Denosumab combined with PFNA surgery might have an advantage in pain relief, BMD T-score, and fracture healing, while reducing refracture risk in elderly patients with osteoporotic ITF Fx compared with PFNA surgery alone.

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地诺单抗联合股骨近端钉防旋转手术治疗老年股骨粗隆间骨折的疗效比较研究

目的评价地诺单抗联合股骨近端钉防旋（PFNA）手术治疗老年骨质疏松性股骨粗隆间骨折（itffx）的疗效。设计和背景：这项回顾性比较研究纳入了2021年7月至2023年7月在淮安市第二人民医院接受PFNA固定的年龄≥65岁的骨质疏松性ITF Fx患者。比较参与者的西班牙缓解（视觉模拟量表，VAS）、髋关节功能、骨密度（BMD）、骨折愈合时间、再骨折率和不良事件。干预措施：这是一项回顾性研究，没有增加任何干预措施。结果共纳入76例患者，其中denosumab + PFNA组38例，PFNA组38例。与PFNA组相比，denosumab + PFNA组在12个月时疼痛缓解（1.68±0.93 vs 2.29±0.97,p = 0.014）和BMD t评分（- 1.49±0.61 vs - 1.98±0.52,p = 0.006）方面的改善显著大于PFNA组。denosumab + PFNA组骨折愈合时间明显缩短(12.37±1.38 vs 13.63±1.34周，p <；0.001)，折射率明显低于(2.63% vs 21.05%, p <；0.05)，高于PFNA组。治疗后髋关节功能在denosumab + PFNA和PFNA组之间具有可比性。denosumab + PFNA组仅报告1例低钙血症（2.63%）。结论与单纯PFNA手术相比，denosumab联合PFNA手术在老年骨质疏松性ITF Fx患者的疼痛缓解、BMD t评分和骨折愈合方面具有优势，同时可降低再骨折风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Bone Reports Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

4.00%

发文量

444

审稿时长

57 days

期刊介绍： Bone Reports is an interdisciplinary forum for the rapid publication of Original Research Articles and Case Reports across basic, translational and clinical aspects of bone and mineral metabolism. The journal publishes papers that are scientifically sound, with the peer review process focused principally on verifying sound methodologies, and correct data analysis and interpretation. We welcome studies either replicating or failing to replicate a previous study, and null findings. We fulfil a critical and current need to enhance research by publishing reproducibility studies and null findings.