Gu Jie, Kang Xin-yong, Xu Hong-wei, Li Yong-fu, Zahng Bin, Guo Jian, He Zhen-nian
Zhongguo Gu Shang. 2016 Jun;29(6):505-8.
To evaluate clinical results of early total care (ETC) treatment for elderly patients with intertrochanteric femur fractures.
Clinical data of 106 elderly patients with intertrochanteric fracture treated from January 2012 and February 2015 were retrospectively studied. According to whether receiving the early total care mode, the patients were divided into 2 groups, 34 cases were diagnosed and treated with early total care pattern (ETC group), including 14 males and 20 females with an average age of (74.88 ± 4.38) years old ranging from 70 to 86. According to Evans types, 4 cases were type I, 5 cases were type II, 13 cases were type III, 11 cases were type IV, 1 case was type V. Seventy-two patients were treated with conventional trauma method (conventional group), including 35 males and 37 females with an average age of (74.46 ± 3.63) years old ranging from 70 to 85. According to Evans type, 8 cases were type I ,13 cases were type II, 25 cases were type III, 25 cases were type IV, and 1 case was type V. All fractures were treated with proximal femoral nails anti-rotation (PFNA). Operative time, hospital stays, leaving bed time, complications, cases of death at 1 year after operation, postoperative Harris score at 12 months were observed and compared.
All patients were followed up, the time of ETC group ranged from 9 to 18 months with an average of 13.29 ± 1.51, and the time in conventional group ranged from 12 to 16 months with an average 12.93 ± 1.15, while there was no significant difference between two groups in time of following-up (t = 1.368, P = 0.174). There was no significant meaning in cases of death between ETC group (2 cases) and conventional group (8 cases). Three cases occurred complications in ETC group, and 20 cases in conventional group,there was obvious meaning between two groups (χ² = 0.739, P = 0.318). Operative time,hospital stays,leaving bed time in ETC group respectively was (2.03 ± 0.67) d, (15.41 ± 2.87) d and (3.62 ± 0.74) d; while in conventional group respectively was (4.17 ± 1.59) d, (20.11 ± 4.24) d and (5.35 ± 1.22) d; there were significant differences between two groups in operative time, hospital stays, leaving bed time. Postoperative Harris scores at 12 months in ETC group was (82.32 ± 4.56), and (79.24 ± 5.52) in conventional group, there was obvious meaning between two groups (t = 2.833, P = 0.006).
ETC pattern is a novel method for diagnosis and treatment of intertrochanteric femur fractures in elderly, it could shorten operative time, hospital stays, leaving bed time, decrease complications and promote recovery of function.
评估早期全面护理（ETC）模式治疗老年股骨转子间骨折的临床效果。
回顾性分析2012年1月至2015年2月收治的106例老年股骨转子间骨折患者的临床资料。根据是否接受早期全面护理模式，将患者分为2组，34例采用早期全面护理模式诊治（ETC组），其中男14例，女20例，平均年龄（74.88±4.38）岁，年龄范围70～86岁。按Evans分型，Ⅰ型4例，Ⅱ型5例，Ⅲ型13例，Ⅳ型11例，Ⅴ型1例。72例采用传统创伤方法治疗（传统组），其中男35例，女37例，平均年龄（74.46±3.63）岁，年龄范围70～85岁。按Evans分型，Ⅰ型8例，Ⅱ型13例，Ⅲ型25例，Ⅳ型25例，Ⅴ型1例。所有骨折均采用股骨近端抗旋髓内钉（PFNA）治疗。观察并比较手术时间、住院时间、下床时间、并发症、术后1年死亡病例数、术后12个月Harris评分。
所有患者均获随访，ETC组随访时间9～18个月，平均（13.29±1.51）个月；传统组随访时间12～16个月，平均（12.93±1.15）个月，两组随访时间差异无统计学意义（t=1.368，P=0.174）。ETC组死亡2例，传统组死亡8例，两组死亡病例数差异无统计学意义。ETC组发生并发症3例，传统组发生并发症20例，两组差异有统计学意义（χ²=0.739，P=0.318）。ETC组手术时间、住院时间、下床时间分别为（2.03±0.67）d、（15.41±2.87）d、（3.62±0.74）d；传统组分别为（4.17±1.59）d、（20.11±4.24）d、（5.35±1.22）d；两组手术时间、住院时间、下床时间差异有统计学意义。ETC组术后12个月Harris评分为（82.32±4.56）分，传统组为（79.24±5.52）分，两组差异有统计学意义（t=2.833，P=0.006）。
ETC模式是老年股骨转子间骨折诊治的一种新方法，可缩短手术时间、住院时间、下床时间，减少并发症，促进功能恢复。
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