Department of Surgery, University of Western Ontario, London, ON, Canada.
Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
J Orthop Trauma. 2019 Jun;33(6):292-300. doi: 10.1097/BOT.0000000000001444.
The FAITH trial evaluated effects of sliding hip screws versus cancellous screws in femoral neck fracture patients. Using FAITH trial data, we quantified changes in living status, use of aids, and investigated factors associated with living and walking independently 12 months after fracture.
We conducted a descriptive analysis to quantify patients' changes in living status, use of aids, and used multivariable Cox regression analyses to determine factors associated with living and walking independently after fracture.
Of patients who lived independently before hip fracture, 3.07% (50-80 years old) and 19.81% (>80 years old) were institutionalized 12 months after injury. Of patients who were walking independently before injury, 33.62% (50-80 years old) and 69.34% (>80 years old) required a walking aid 12 months after injury. Factors associated with higher chances of living independently included the following: being between 50 and 80 years, having a class I American Society of Anesthesiologists classification, not using a walking aid before fracture, being a nonsmoker or former smoker, and having an acceptable quality of implant placement. Factors associated with higher chances of walking without an aid included the following: being between 50 and 80 years, having a class I American Society of Anesthesiologists classification, living independently before fracture, being a nonsmoker or former smoker, having an undisplaced fracture, and not requiring revision surgery.
Femoral neck fracture patients suffer great losses of independence. Identifying factors associated with living and walking independently after hip fracture may help surgeons better identify which patients are at risk and optimize care of patients with this injury.
Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
FAITH 试验评估了滑动髋螺钉与股骨颈骨折患者松质骨螺钉的疗效。我们使用 FAITH 试验数据，量化了生活状态的变化、辅助工具的使用，并调查了与骨折后 12 个月独立生活和行走相关的因素。
我们进行了描述性分析，以量化患者生活状态和辅助工具使用的变化，并使用多变量 Cox 回归分析来确定与骨折后独立生活和行走相关的因素。
在髋部骨折前独立生活的患者中，3.07%（50-80 岁）和 19.81%（>80 岁）在受伤后 12 个月内住进了疗养院。在受伤前独立行走的患者中，33.62%（50-80 岁）和 69.34%（>80 岁）在受伤后 12 个月需要使用助行器。与更高独立生活机会相关的因素包括：年龄在 50-80 岁之间、美国麻醉医师协会（ASA）分级为 I 级、骨折前未使用助行器、不吸烟或曾经吸烟、以及植入物位置的可接受质量。与更高独立行走机会相关的因素包括：年龄在 50-80 岁之间、ASA 分级为 I 级、骨折前独立生活、不吸烟或曾经吸烟、骨折无移位、且无需进行翻修手术。
股骨颈骨折患者的独立性受到严重影响。确定与髋部骨折后独立生活和行走相关的因素，可能有助于外科医生更好地识别哪些患者存在风险，并优化对这类损伤患者的护理。
预后 II 级。请参阅作者说明以获取完整的证据等级描述。
