To investigate the effect of denosumab injection combined with calcium carbonate D3 tablets on the recovery of elderly patients with intertrochanteric fracture of femur (IFF) after intramedullary nail fixation.

A retrospective collection of case data was conducted on 80 elderly IFF patients who underwent proximal femoral anti rotation intramedullary nail fixation surgery in the hospital from February 2022 to February 2025. According to different postoperative treatment plans, the patients were divided into a control group (treated with calcium carbonate D3 tablets, 38 cases) and an observation group (treated with denosumab injection combined with calcium carbonate D3 tablets, 42 cases). Both groups were treated for 12 months. The bone density values, bone formation and resorption markers [osteocalcin (BGP), type I procollagen N-terminal propeptide (PINP), alkaline phosphatase (BALP), and tartrate resistant acid phosphatase (TRACP-5b)], inflammatory markers [C-reactive protein (CRP), interleukin-6 (IL-6), erythrocyte sedimentation rate (ESR)], excellent hip joint function rate, and incidence of complications and adverse reactions were compared between two groups.

The bone density values between the femoral neck and trochanter in both groups after 6 and 12 months of treatment gradually increased compared to before treatment, and were higher after 12 months of treatment than after 6 months of treatment (P<0.05). Further inter group comparison showed that the bone density values between the femoral neck and trochanter in the observation group were higher than those in the control group at 6 and 12 months of treatment (P<0.05). After 12 months of treatment, serum BGP, PINP, and BALP levels increased in both groups, while TRACP-5b levels decreased, with the observation group showing more significant changes (P<0.05). After 12 months of treatment, the levels of various inflammatory indicators in both groups decreased, and the observation group had even lower levels (P<0.05). After 12 months of treatment, compared with the control group, the observation group showed a significant increase in the rate of excellent hip joint function and a significant decrease in the rate of recurrent fractures (P<0.05). There was no significant difference in the incidence of nonunion, delayed union, and internal fixation failure between the two groups (P>0.05).

The combination of denosumab injection and calcium carbonate D3 tablets can not only improve bone density and metabolism in elderly patients with IFF, but also alleviate inflammatory reactions, improve hip joint function, and reduce the risk of recurrent fractures.