Hay D, Parker M J
Orthopaedic Department, Peterborough District Hospital, England.
J Bone Joint Surg Br. 2003 Sep;85(7):1037-9. doi: 10.1302/0301-620x.85b7.14372.
Immobility has been used as an indication for conservative treatment of patients with fractures of the hip, although there is little in the literature to support this view. We conducted a prospective review of 3515 patients with hip fractures of whom 152 (4.3%) were immobile prior to the fracture. Nine patients were treated conservatively, the rest by operation. The mean age was 83 years (42 to 99); the mean length of hospital stay was 17.8 days; 19 patients (12.5%) died whilst still in hospital and 120 (79.0%) went back to their original residence. There were 38 post-operative complications. At one year after injury, 73 patients were still alive. Of the survivors, 54 (74.0%) had none or minimal pain in the hip and 58 (79.5%) had the same residential status as before the fracture. Immobility in patients with hip fracture is uncommon and is not a valid reason for withholding surgical treatment.
尽管文献中几乎没有支持该观点的内容，但长期卧床一直被用作髋部骨折患者保守治疗的指征。我们对3515例髋部骨折患者进行了一项前瞻性研究，其中152例（4.3%）在骨折前长期卧床。9例患者接受了保守治疗，其余患者接受了手术治疗。平均年龄为83岁（42至99岁）；平均住院时间为17.8天；19例患者（12.5%）在住院期间死亡，120例患者（79.0%）返回原居住地。术后有38例并发症。受伤一年后，73例患者仍存活。在幸存者中，54例（74.0%）髋部无疼痛或仅有轻微疼痛，58例（79.5%）的居住状况与骨折前相同。髋部骨折患者长期卧床的情况并不常见，也不是拒绝手术治疗的有效理由。
