Abstract Objective To investigate the clinical efficacy of denosumab injection combined with intramedullary nail fixation for osteoporotic femoral intertrochanteric fractures. Methods A total of 106 patients diagnosed with osteoporotic femoral intertrochanteric fractures, classified according to the Evans–Jensen system, who were admitted to The First Affiliated Hospital of Guangzhou University of Chinese Medicine between May 2019 and May 2024. All patients underwent internal fixation using the proximal femoral nail antirotation (PFNA) system. The study group received denosumab injections within 1 week postoperatively, and both groups were administered conventional osteoporosis treatment following surgery. The baseline data (age, sex, cause of injury, and Evans–Jensen classification), operation time, intraoperative blood loss, length of hospital stay, fracture healing time, T value of hip bone density, and postoperative complications were compared between these two groups. The VAS score and HHS was evaluated 1 year after surgery. Results All 106 patients were followed up for at least 1 year. There was no significant difference in operation time, intraoperative blood loss, hospital stays, fracture healing time, and HHS between the two groups ( P > 0.05). The incidence of postoperative complications, T value of hip bone density, and VAS score in the study group was significantly lower than that in the control group, and the difference between the groups was statistically significant ( P < 0.05). Conclusion In summary, the integrative therapeutic protocol combining denosumab administration with proximal femoral nail antirotation (PFNA) fixation demonstrates marked efficacy in enhancing femoral neck bone mineral density and reducing fracture-related limb pain among elderly patients with osteoporotic intertrochanteric fractures. This evidence-based dual-intervention strategy not only optimizes fracture healing outcomes, but also represents a valuable clinical approach for comprehensive postoperative rehabilitation in this vulnerable patient population.
Cai et al. (Tue,) studied this question.