Wydra Tomasz, Matuszewski Przemysław, Baranowska Alicja, Dąbrowski Piotr, Mikuła Wojciech, Kiwerska-Jagodzińska Katarzyna
Department of Traumatic Orthopedic, Mazovian Rehabilitation Centre STOCER, Konstancin-Jeziorna, Poland.
Pol Merkur Lekarski. 2019 Feb 28;46(272):72-76.
Good functional efficiency of patients after surgical treatment of proximal femur fracture may be associated with the presence of preoperative loads.
The aim of the study was to analyze the impact of preoperative loads on the functional outcome of surgical treatment and the presence of complications observed in the perioperative period in patients with previous BKKU fractures.
A retrospective analysis included 202 patients with proximal femur fractures undergoing surgery, including 146 women aged 80.1 +/- 15.4 years and 56 men aged 74.3 +/- 13.2 years. The patients were divided according to the type of fracture into two groups. The first group consisted of 120 patients (91 women and 29 men) with intertrochanteric fractures and the second group consisting of 82 patients (55 women and 27 men) with femoral neck fractures. The analysis takes into account the influence of chronic co-morbidities on the treatment method used and the outcome of the treatment, taking into account the greatest possible independence in the daily activities of the operated patients.
In 85% of surgical patients treated for proximal femur fractures, concomitant diseases were observed in the pre-operative period. 28 of them were disqualified from surgery. In the remaining 38 patients perioperative complications were observed, including prolonged bleeding, infection and exacerbation of renal failure. The most unfavorable complication in the analysis was renal failure.
Patients in the age group predisposing to proximal femur fractures should be carefully monitored for co-morbid chronic diseases. This action may reduce the percentage of disqualification from surgical treatment and the risk of perioperative complications.
股骨近端骨折手术治疗后患者良好的功能效率可能与术前负荷的存在有关。
本研究的目的是分析术前负荷对手术治疗功能结果的影响以及既往有股骨近端骨折患者围手术期观察到的并发症情况。
一项回顾性分析纳入了202例接受股骨近端骨折手术的患者,其中包括146名年龄为80.1±15.4岁的女性和56名年龄为74.3±13.2岁的男性。根据骨折类型将患者分为两组。第一组由120例(91名女性和29名男性)转子间骨折患者组成,第二组由82例(55名女性和27名男性)股骨颈骨折患者组成。分析考虑了慢性合并症对所采用治疗方法和治疗结果的影响,同时考虑手术患者日常活动中最大可能的独立性。
在接受股骨近端骨折手术治疗的患者中,85%在术前观察到合并疾病。其中28例被取消手术资格。在其余38例患者中观察到围手术期并发症,包括出血时间延长、感染和肾衰竭加重。分析中最不利的并发症是肾衰竭。
对于易发生股骨近端骨折的年龄组患者,应仔细监测其慢性合并疾病。这一措施可能会降低手术治疗取消率和围手术期并发症的风险。