Hongisto Markus T, Pihlajamäki Harri, Niemi Seppo, Nuotio Maria, Kannus Pekka, Mattila Ville M
Division of Orthopedics and Traumatology, Seinäjoki Central Hospital, Hanneksenrinne 7, 60220, Seinäjoki, Finland,
Int Orthop. 2014 Aug;38(8):1685-90. doi: 10.1007/s00264-014-2346-6. Epub 2014 Apr 23.
For femoral neck fractures, recent scientific evidence supports cemented hemiarthroplasty (HA) over uncemented HA and suggests that total hip arthroplasty (THA) should be performed more frequently. We report the current surgical trends in treating femoral neck fractures in Finland.
The study was conducted using the Finnish National Hospital Discharge Register and included all Finns at least 50 years of age who underwent surgery for femoral neck fractures from 1998 through 2011. Age- and sex-specific incidence rates and annual proportion of each treatment method were calculated.
During 1998-2011, a total of 49,514 operations for femoral neck fracture were performed in Finland. The proportion of uncemented HA increased from 8.1% in 2005 to 22.2% in 2011. During the same time, the proportion of cemented HA decreased from 63.9 to 52.5%, internal fixation decreased from 23.2 to 16.1% and THA increased from 4.9 to 9.2%.
Between 2005 and 2011, the proportion of uncemented HA for femoral neck fractures increased markedly in Finland, while cemented HA and internal fixation declined. During this time, the use of THA nearly doubled. The current evidence-based guidelines for treatment of femoral neck fractures were mainly followed, but the increase in uncemented HA procedures contradicts recent scientific evidence.
对于股骨颈骨折，近期科学证据支持骨水泥半髋关节置换术（HA）优于非骨水泥型HA，并表明全髋关节置换术（THA）应更频繁地进行。我们报告了芬兰治疗股骨颈骨折的当前手术趋势。
本研究使用芬兰国家医院出院登记册，纳入了1998年至2011年期间所有至少50岁且接受股骨颈骨折手术的芬兰人。计算了各治疗方法的年龄和性别特异性发病率以及每年的比例。
1998年至2011年期间，芬兰共进行了49,514例股骨颈骨折手术。非骨水泥型HA的比例从2005年的8.1%增加到2011年的22.2%。与此同时，骨水泥型HA的比例从63.9%降至52.5%，内固定从23.2%降至16.1%，而THA从4.9%增至9.2%。
2005年至2011年期间，芬兰股骨颈骨折非骨水泥型HA的比例显著增加，而骨水泥型HA和内固定则有所下降。在此期间，THA的使用量几乎翻了一番。目前主要遵循了基于证据的股骨颈骨折治疗指南，但非骨水泥型HA手术的增加与近期科学证据相矛盾。
