Li Qing-Qing, Gui Xian-Ge, Jiang Zeng-Hui, Ru Xuan-Liang
The First Department of Orthopaedics, Zhejiang Hospital, Hangzhou 310013, Zhejiang, China.
The First Department of Orthopaedics, Zhejiang Hospital, Hangzhou 310013, Zhejiang, China;
Zhongguo Gu Shang. 2018 May 25;31(5):408-412. doi: 10.3969/j.issn.1003-0034.2018.05.003.
To investigate the risk factors of functional recovery after intramedullary nail fixation for femoral intertrochanteric fracture in elderly patients, and to propose corresponding measures to promote postoperative hip function recovery.
From June 2012 to June 2015, 74 patients after intramedullary nail fixation surgery were analyzed, including 33 males and 41 females, with an average age of(75.07±7.89) years old, and divided into well-function group(55 patients) and bad-function group(19 patients) according to Sanders function criterion. Age, gender, bone density, fracture type, systemic disease, complication, rehabilitation exercises with therapist or not, nourishment state, anesthesia method, fracture reduction condition, ASA classification, tip apex distance were reviewed and analyzed by t test, non-parametric test, χ² test and Logistic analysis.
Univariate analysis showed that age, bone density, nourishment state, ASA classification, anesthesia method, fracture reduction condition, rehabilitation exercises with therapist, and tip apex distance were the risk factors for the recovery of hip function. Logistic analysis showed that bone density(0.006, OR=0.077), rehabilitation exercises with therapist(0.006, OR=0.070), ASA classification(<0.001, OR=0.049), nourishment state (0.046, OR=0.188) were the risk factors for the functional recovery.
Bone density, rehabilitation exercises with therapist, ASA classification, nourishment state were the risk factors for the functional recovery of intramedullary nail fixation for intertrochanteric fracture in elderly patients. Multidisciplinary cooperation and fast track surgery system should be set up to promoting the hip functional recovery.
探讨老年股骨转子间骨折髓内钉固定术后功能恢复的危险因素，并提出促进术后髋关节功能恢复的相应措施。
分析2012年6月至2015年6月行髓内钉固定手术的74例患者，其中男33例，女41例，平均年龄（75.07±7.89）岁，根据Sanders功能标准分为功能良好组（55例）和功能不良组（19例）。采用t检验、非参数检验、χ²检验和Logistic分析对年龄、性别、骨密度、骨折类型、全身疾病、并发症、是否接受治疗师康复锻炼、营养状况、麻醉方式、骨折复位情况、ASA分级、尖顶距进行回顾性分析。
单因素分析显示年龄、骨密度、营养状况、ASA分级、麻醉方式、骨折复位情况、接受治疗师康复锻炼、尖顶距是髋关节功能恢复的危险因素。Logistic分析显示骨密度（0.006，OR=0.077）、接受治疗师康复锻炼（0.006，OR=0.070）、ASA分级（<0.001，OR=0.049）、营养状况（0.046，OR=0.188）是功能恢复的危险因素。
骨密度、接受治疗师康复锻炼、ASA分级、营养状况是老年股骨转子间骨折髓内钉固定术后功能恢复的危险因素。应建立多学科协作和快速康复手术体系以促进髋关节功能恢复。
