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在老年患者股骨粗隆间骨折的初次治疗中采用限制性关节成形术时,高合并症指数与高发病率和死亡率无关。

High comorbidity index is not associated with high morbidity and mortality when employing constrained arthroplasty as a primary treatment for intertrochanteric fractures in elderly patients.

作者信息

Maroun Gilbert, Chaftari Raja, Chokr Jad, Maroun Charbel, El-Jerdi Moussa, Saade Charbel

机构信息

Diagnostic Radiology Department, American University of Beirut Medical Center, P.O.Box: 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon.

Department of Orthopedic Surgery, Geitaoui Lebanese Hospital, P.O.Box: 175086, Beirut, 1107 2020, Lebanon.

出版信息

Eur J Orthop Surg Traumatol. 2019 Jul;29(5):1009-1015. doi: 10.1007/s00590-019-02394-7. Epub 2019 Feb 9.

DOI:10.1007/s00590-019-02394-7
PMID:30739162
Abstract

AIM

The aim of our study is to investigate the results of constrained total hip arthroplasty as a primary treatment of intertrochanteric fractures (ITF) in elderly patients with high comorbidities.

MATERIALS AND METHODS

Total hip replacement (THR) with a retentive cup was performed on 73 patients with ITF over the age of 54 years who had high comorbidities and a Charlson score above five. Short- and long-term complications were determined by follow-up. Bivariate analysis was conducted in order to determine the possible determinants of mortality and factors associated with comorbidity as measured by the Charlson comorbidities index.

RESULTS

Patient demographics that consisted of females (58.9%) (p < 0.04) with the mean age of both males and females demonstrated no statistical significance. The mean hospitalization time and weight bearing time were 11 and 2.67 days, respectively. Only 4.1% needed re-intervention due to re-fracture and none due to prosthesis failure. There was a statistical significance between the comorbidity index and the mortality rate. However, no statistical significance was identified between the comorbidity index and the functional status after constrained THR.

CONCLUSION

High comorbidity index is not associated with high morbidity and mortality when employing constrained arthroplasty as a primary treatment for ITF in elderly patients.

摘要

目的

我们研究的目的是调查限制性全髋关节置换术作为合并症多的老年患者粗隆间骨折(ITF)主要治疗方法的效果。

材料与方法

对73例年龄超过54岁、合并症多且查尔森评分高于5分的ITF患者进行带固定杯的全髋关节置换术(THR)。通过随访确定短期和长期并发症。进行双变量分析以确定死亡率的可能决定因素以及由查尔森合并症指数衡量的与合并症相关的因素。

结果

患者人口统计学数据显示,女性占58.9%(p < 0.04),男性和女性的平均年龄无统计学差异。平均住院时间和负重时间分别为11天和2.67天。仅4.1% 的患者因再次骨折需要再次干预,无患者因假体失败需要再次干预。合并症指数与死亡率之间存在统计学差异。然而,在限制性THR后,合并症指数与功能状态之间未发现统计学差异。

结论

对于老年患者,采用限制性关节成形术作为ITF的主要治疗方法时,高合并症指数与高发病率和死亡率无关。

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Risk factors for mortality in geriatric hip fractures: a compressional study of different surgical procedures in 785 consecutive patients.老年髋部骨折患者死亡的危险因素:对785例连续患者不同手术方式的对比研究
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老年患者股骨转子间骨折手术治疗后 Charlson 共病指数、早期恢复与 2 年死亡率的关系:回顾性分析。
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Bipolar Hemiarthroplasty should not be selected as the primary option for intertrochanteric fractures in elderly patients.双相髋关节成形术不应作为老年患者股骨转子间骨折的首选方案。
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