Slobogean Gerard P, Stockton David J, Zeng Bingfang, Wang Dong, Ma Bao-Tong, Pollak Andrew N
From the Department of Orthopaedics, University of Maryland, Baltimore, MD (Dr. Slobogean), the Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada (Dr. Stockton), the Shanghai Sixth People's Hospital, Shanghai, China (Dr. Zeng), the Second Affiliated Hospital to Shanxi University, Shanghai, China (Dr. Wang), the Department of Traumatic Orthopedics, Tianjin Hospital, Tianjin, China (Dr. Ma), and the R. Adams Cowley Shock Trauma Center, Baltimore (Dr. Pollak).
J Am Acad Orthop Surg. 2017 Apr;25(4):297-303. doi: 10.5435/JAAOS-D-15-00661.
Although femoral neck fractures in young patients are rare and their complications are well-documented, there is a paucity of data on patient-reported outcomes for this population. The purpose of this study was to describe the quality of life and the effect of clinical complications on the outcomes of young patients with femoral neck fractures in a Chinese cohort.
In this prospective observational cohort study, patients aged 18 to 55 years admitted to one of three participating trauma hospitals in China for treatment of a femoral neck fracture were recruited. The primary outcome was the patient's health-related quality of life using the Medical Outcomes Study 36-Item Short Form (SF-36) Health Survey at 1 year after injury. Associations between the primary outcome and potential predictors were explored with univariate and multivariate regression analysis.
One hundred seven patients (mean age, 44 years) completed 1-year follow-up. Nearly all patients were treated with closed reduction and screw fixation. Nine cases of nonunion, 7 cases of malunion, and 11 cases of osteonecrosis were identified. The mean SF-36 Physical Component Score was 48.6 ± 8.5, and the mean Mental Component Score was 51.0 ± 7.4. Fracture displacement, quality of reduction, and nonunion were associated with a poor Physical Component Score outcome.
Our results demonstrate that the quality of life for patients after closed reduction and screw fixation of femoral neck fractures is similar to that of the general population, particularly when complications of nonunion and malunion are avoided.
Level I.
尽管年轻患者的股骨颈骨折较为罕见，且其并发症已有充分记录，但关于该人群患者报告结局的数据却很少。本研究的目的是描述中国队列中年轻股骨颈骨折患者的生活质量以及临床并发症对其结局的影响。
在这项前瞻性观察性队列研究中，招募了在中国三家参与研究的创伤医院之一因股骨颈骨折入院治疗的18至55岁患者。主要结局是受伤1年后使用医学结局研究36项简短健康调查（SF-36）对患者健康相关生活质量进行评估。通过单变量和多变量回归分析探讨主要结局与潜在预测因素之间的关联。
107例患者（平均年龄44岁）完成了1年随访。几乎所有患者均接受了闭合复位螺钉内固定治疗。发现9例骨不连、7例畸形愈合和11例骨坏死。SF-36身体成分评分的平均值为48.6±8.5，精神成分评分的平均值为51.0±7.4。骨折移位、复位质量和骨不连与较差的身体成分评分结局相关。
我们的结果表明，股骨颈骨折闭合复位螺钉内固定术后患者的生活质量与一般人群相似，尤其是在避免骨不连和畸形愈合并发症的情况下。
I级。
