Royal Orthopaedic Hospital, Birmingham, United Kingdom.
Epsom and St. Helier University Hospitals, London, United Kingdom.
Injury. 2021 Apr;52(4):914-917. doi: 10.1016/j.injury.2020.10.017. Epub 2020 Oct 5.
Lower limb amputees, regardless of age are at an increased risk of developing fragility fractures of the neck of femur. The characteristics and outcomes of the fractures of the neck of femur in lower limb amputees have not been studied in detail.
We undertook a retrospective review of a prospectively collected single centre and single surgeon database between March 1996 and January 2017, using a standard proforma to identify patients who required surgical intervention for fracture neck of femur and had sustained a previous lower limb amputation and compared them with a cohort of standard hip fracture patients.
Twenty-seven patients, sustaining 28 fractures of the neck of femurs were identified of which 16 were females with mean age of 78 years (50-89). Nineteen fractures were sustained on the ipsilateral side of the amputation. Results showed that seventy percent of amputees returned to their previous level of mobility and prior residence. Mortality in this group is higher as compared to a standard hip fracture patient but pain and mobility were comparable in both groups.
The incidence of both hip fractures and amputations in increasing worldwide but no study has compared outcomes of hip fractures in amputees and compared them to a standard hip fracture patient. Amputees exhibit reduced bone density both at the hip and stump end which increases risk for osteoporosis and fragility fractures in the hip. The management of our patients followed orthopaedic principles, well established surgical interventions and rehabilitation.
This study reveals that hip fractures in amputees can have comparable results to a standard hip fracture cohort if preoperative optimisation, planning and postoperative rehabilitation is carried out.
下肢截肢者，无论年龄大小，都有更高的风险发生股骨颈脆弱性骨折。下肢截肢者的股骨颈骨折的特征和结果尚未详细研究。
我们对 1996 年 3 月至 2017 年 1 月期间前瞻性收集的单一中心和单一外科医生数据库进行了回顾性研究，使用标准表格识别需要手术干预股骨颈骨折且先前有下肢截肢的患者，并将其与标准髋部骨折患者的队列进行比较。
共确定了 27 例患者（28 例股骨颈骨折），其中 16 例为女性，平均年龄为 78 岁（50-89 岁）。19 例骨折发生在截肢的同侧。结果表明，70%的截肢者恢复到之前的活动水平和先前的居住环境。与标准髋部骨折患者相比，该组的死亡率更高，但两组的疼痛和活动能力相当。
全球范围内髋部骨折和截肢的发生率都在增加，但没有研究比较过截肢者髋部骨折的结果，并将其与标准髋部骨折患者进行比较。截肢者在髋部和残端都表现出较低的骨密度，这增加了髋部骨质疏松症和脆弱性骨折的风险。我们的患者管理遵循骨科原则、成熟的手术干预和康复。
这项研究表明，如果进行术前优化、规划和术后康复，髋部骨折的截肢者可以获得与标准髋部骨折患者相当的结果。
