Cengiz Ömer, Polat Gökhan, Karademir Gökhan, Tunç Oytun Derya, Erdil Mehmet, Tuncay İbrahim, Şen Cengiz
Department of Orthopedics and Traumatology, Faculty of Medicine, Bezmialem University, Fatih, 34050 Istanbul, Turkey.
Department of Orthopedics and Traumatology, Istanbul Faculty of Medicine, Istanbul University, Çapa Fatih, 34050 Istanbul, Turkey.
Adv Orthop. 2016;2016:3703482. doi: 10.1155/2016/3703482. Epub 2016 Mar 22.
We aimed to evaluate the effects of intertrochanteric femoral fractures on mortality, morbidity, and cost of zoledronate treatment in elderly patients treated by osteosynthesis. Based on Evans classification, 114 patients with unstable intertrochanteric femoral fractures were treated with osteosynthesis. After the surgical treatment of intertrochanteric fractures, the treatment group (M/F, 24/32; mean age, 76.7 ± SD years) received zoledronate infusion, and the control group (M/F, 20/38; mean age, 80.2 ± SD years) received placebo. Postoperative control visits were performed at 6-week, 3-month, 6-month, and 12-month time points. Functional level of patients was evaluated by the modified Harris hip score and Merle d'Aubigné hip score. By 12 months, the mean HHS in treatment and control groups was 81.93 and 72.9, respectively. For time of death of the patients, mortality was found to be 57.1% (16/28) on the first 3 months and 92.9% (26/28) on the first six months. The mortality rate in the treatment and control groups was 14.3% (8/56) and 34.5% (20/58), respectively. The use of zoledronic acid after surgical treatment of intertrochanteric femoral fractures in osteoporotic elderly patients is a safe treatment modality which helps to reduce mortality, improves functional outcomes, and has less side effects with single dose use per year.
我们旨在评估股骨粗隆间骨折对接受骨合成治疗的老年患者的死亡率、发病率以及唑来膦酸治疗费用的影响。根据埃文斯分类法,对114例不稳定型股骨粗隆间骨折患者进行了骨合成治疗。股骨粗隆间骨折手术治疗后,治疗组(男/女,24/32;平均年龄,76.7±标准差岁)接受唑来膦酸输注,对照组(男/女,20/38;平均年龄,80.2±标准差岁)接受安慰剂。在术后6周、3个月、6个月和12个月时间点进行随访。通过改良Harris髋关节评分和Merle d'Aubigné髋关节评分评估患者的功能水平。到12个月时,治疗组和对照组的平均HHS分别为81.93和72.9。对于患者的死亡时间,发现前3个月的死亡率为57.1%(16/28),前6个月为92.9%(26/28)。治疗组和对照组的死亡率分别为14.3%(8/56)和34.5%(20/58)。在骨质疏松老年患者股骨粗隆间骨折手术治疗后使用唑来膦酸是一种安全的治疗方式,有助于降低死亡率,改善功能结局,且每年单剂量使用副作用较少。