Cho Yoon Je, Chun Young Soo, Rhyu Kee Hyung, Kang Joon Soon, Jung Gwang Young, Lee Jun Hee
Department of Orthopedic Surgery, Kyung Hee University School of Medicine, Seoul, Korea.
Department of Orthopedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
Hip Pelvis. 2015 Dec;27(4):258-64. doi: 10.5371/hp.2015.27.4.258. Epub 2015 Dec 30.
This study was designed to investigate the effect of bisphosphonate administration starting time on bone healing and to identify the best administration time following surgical treatment of osteoporotic intertrochanteric fractures.
Two hundreds and eighty four patients (284 hips; 52 males, 232 females) who underwent surgery following osteoporotic intertrochanteric fracture from December 2002 to December 2012 were retrospectively analyzed. The average follow-up period was 68.4 months. The patients were divided into three groups according to the time of bisphosphonate administration after operation: 1 week (group A; n=102), 1 month (group B; n=89), and 3 months (group C; n=93). Koval scores and change of Koval scores 1 year after operation were used for clinical evaluation. For radiologic evaluation, the time of callus appearance across the fracture line on sagittal and coronal radiographs and the time to absence of pain during hip motion was judged as the time of bone union.
Koval scores one year after surgery for groups A, B, and C were 2.44, 2.36, and 2.43 (P=0.895), respectively. The mean time of union was 12.4, 11.9, and 12.3 weeks after operation in the three groups (P=0.883), respectively. There were zero cases of nonunion. There were 3, 5, and 7 cases of fixative displacement in the three groups, respectively, but the distribution showed no significant difference (P>0.472).
The initiating time of bisphosphonate administration following surgery does not affect the clinical outcomes in patients with osteoporotic intertrochanteric fracture.
本研究旨在探讨双膦酸盐给药起始时间对骨愈合的影响，并确定骨质疏松性股骨转子间骨折手术治疗后的最佳给药时间。
回顾性分析2002年12月至2012年12月间因骨质疏松性股骨转子间骨折接受手术的284例患者（284髋；男性52例，女性232例）。平均随访期为68.4个月。根据术后双膦酸盐给药时间将患者分为三组：1周（A组；n = 102）、1个月（B组；n = 89）和3个月（C组；n = 93）。采用Koval评分及术后1年Koval评分的变化进行临床评估。对于影像学评估，将矢状位和冠状位X线片上骨折线处骨痂出现的时间以及髋关节活动时无疼痛的时间判定为骨愈合时间。
A组、B组和C组术后1年的Koval评分分别为2.44、2.36和2.43（P = 0.895）。三组术后平均愈合时间分别为12.4周、11.9周和12.3周（P = 0.883）。无骨不连病例。三组分别有3例、5例和7例固定移位，但分布无显著差异（P>0.472）。
骨质疏松性股骨转子间骨折患者术后双膦酸盐给药起始时间不影响临床疗效。
