Hong Choon Chiet, Nashi Nazrul, Makandura Milindu Chanaka, Krishna Lingaraj
Department of Orthopaedic Surgery, University Orthopaedics, Hand and Reconstructive Microsurgery Cluster, National University Hospital, Singapore.
Singapore Med J. 2016 Feb;57(2):69-72. doi: 10.11622/smedj.2016030.
Traumatic displaced femoral neck fractures in the elderly can be treated with cemented or uncemented hemiarthroplasty with good outcomes. Earlier studies reported a higher incidence of deep vein thrombosis (DVT) associated with cemented prostheses in elective total hip or knee arthroplasty. In addition, the hypercoagulable state after a traumatic femoral neck fracture and possible thrombogenic properties of bone cement could put these patients at greater risk for thromboembolism. We aimed to compare the incidence of DVT and progression to pulmonary embolism (PE) or mortality in cemented and uncemented hemiarthroplasty.
The data of 271 patients treated with cemented or uncemented hemiarthroplasty after a traumatic displaced femoral neck fracture was retrospectively analysed for the incidence of DVT. The level of thrombosis, progression to PE and mortality were compared.
There were 133 (49.1%) patients with cemented hemiarthroplasty, while 138 (50.9%) had uncemented hemiarthroplasty. The patients had an average age of 76.6 (range 53-99) years and 11 (4.1%) patients had DVT. There were no significant differences in development of DVT, level of thrombosis, PE and mortality regardless of whether a cemented or an uncemented prosthesis was used.
Cemented hemiarthroplasty is not associated with higher risks of DVT, PE or mortality in patients with traumatic displaced femoral neck fracture. Cemented prostheses can be safely used for this group of patients.
老年创伤性移位股骨颈骨折可采用骨水泥型或非骨水泥型半髋关节置换术治疗，效果良好。早期研究报告称，在择期全髋关节或膝关节置换术中，骨水泥型假体相关的深静脉血栓形成（DVT）发生率较高。此外，创伤性股骨颈骨折后的高凝状态以及骨水泥可能的致血栓特性可能使这些患者发生血栓栓塞的风险更高。我们旨在比较骨水泥型和非骨水泥型半髋关节置换术中DVT的发生率以及进展为肺栓塞（PE）或死亡率。
回顾性分析271例创伤性移位股骨颈骨折后接受骨水泥型或非骨水泥型半髋关节置换术患者的DVT发生率。比较血栓形成水平、进展为PE的情况和死亡率。
133例（49.1%）患者接受了骨水泥型半髋关节置换术，138例（50.9%）接受了非骨水泥型半髋关节置换术。患者平均年龄为76.6岁（范围53 - 99岁），11例（4.1%）患者发生了DVT。无论使用骨水泥型还是非骨水泥型假体，DVT的发生、血栓形成水平、PE和死亡率均无显著差异。
对于创伤性移位股骨颈骨折患者，骨水泥型半髋关节置换术与DVT、PE或死亡率的较高风险无关。骨水泥型假体可安全用于这组患者。
