To investigate the effect of proximal femur nail anti-rotation (PFNA) on the treatmeng of elderly patients with intertrochanteric femoral fracture, and to investigate the changes of tumer necrosis factor-α (TNF-α), interleukin-6(IL-6) and IL-10.

A total of 100 elderly patients with intertrochanteric femoral fracture who were treated in the Department of Traumatic Joint Surgery, Second Hospital of Qinhuangdao from August 2015 to May 2018 were selected as the research subjects. According to different treatment methods, they were divided into 2 groups: control group and study group, with 50 cases in each group. The control group received anatomic proximal femoral locking plate(APFLP) internal fixation. The patient took supine position under general anesthesia. All the locations from the base of the femoral neck to above the level of the lesser trochanter were exposed, and the displaced fracture was reduced. After the reduction was satisfactory, the anatomical plate and locking nail were fixed. The study group underwent PFNA internal fixation. The patient took supine position under general anesthesia. Under the fluoroscopy of C-arm machine, the appropriate PFNA main nail was selected. Under the fluoroscopy, the position of the proximal guide needle was satisfactory, and the guide needle was driven into the appropriate anti-rotation blade. At the distal end, a lock nail was screwed into through the sight. The changes of serum TNF-α, IL-6 and IL-10 levels in the 2 groups before and 1 week after surgery and the clinical therapeutic effect of the 2 groups 6 months after surgery were observed and compared. Data were processed with t test and χ² test.

The serum levels of TNF-α, IL-6 and IL-10 in the study group were (19.31±2.11), (8.66±3.74) and (4.27±1.16) μg/L before operation, respectively, and those in the control group were (20.16±1.86), (7.53±2.38) and (5.18±1.93) μg/L, respectively, there were no statistically significant differences between the 2 groups (P> 0.05). One week after operation, the serum levels of TNF-α, IL-6 and IL-10 in the study group were (32.52±3.26), (12.31±3.53) and (10.33±1.47) μg/L, respectively, which were significantly lower than those in the control group [(38.56±5.74), (17.52±2.87) and (16.18±2.72) μg/L], there were statistically significant differences between the 2 groups (t=13.181, 12.968, 13.382; P<0.05). The effective rate in the study group 6 months after surgery was 96.0% (48/50), which was significantly higher than that in the control group [80.0%(40/50)], and the difference was statistically significant (χ²=7.662, P<0.05).

The application of PFNA internal fixation in the treatmeng of elderly intertrochanteric femoral fracture has an ideal effect. PFNA internal fixation has the characteristics of small trauma, quick recovery, and can significantly reduce serum TNF-α, IL-6, IL-10 levels.