Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, No. 201, Sec 2, Shi-Pai Road, Taipei City, 112, Taiwan, ROC.
Department of Orthopaedics, School of Medicine, National Yang-Ming University, No. 201, Sec. 2, Shipai Rd, Beitou District, Taipei City, 11217, Taiwan, ROC.
Sci Rep. 2020 Dec 3;10(1):21016. doi: 10.1038/s41598-020-78168-7.
Patients with Idiopathic Parkinson's Disease (PD) have an increased risk for fractures. Currently, many studies have reported inferior outcomes in PD patients after orthopedic procedures. However, there are very few studies assessing the outcome of upper extremity fractures (UEF) in PD patients. In this study, we reviewed 40 patients with PD that received surgical intervention for an UEF. We retrospectively reviewed patients with PD that received surgical fixation for an UEF at a tertiary trauma center. The primary objective was to determine the treatment failure rate after surgical fixation. The secondary outcomes include mode of failure, time to treatment failure, length of hospital stay, readmission rate, reoperation rate, and postoperative complications. A total of 40 patients with PD (42 fractures) underwent surgery. The most common fracture type was radius fracture (n = 19), followed by humerus fracture (n = 15), metacarpal/phalangeal fracture (n = 5), clavicle fracture (n = 2) and olecranon fracture (n = 1). The overall treatment failure rate was 40.5% (n = 17). The time to treatment failure was 1.24 ± 3.1 months and length of hospital stay was 6 ± 3.9 days, the readmission rate within 30 days was 14% (n = 6), and reoperation rate was 14% (n = 6). The complication rate was 16.6% (n = 7) and patients with humeral fractures appeared to have the longest hospital stays (6.6 days) and increased complication rates (13%, n = 2). Patients with PD have high treatment failure rates despite surgical fixation of an UEF. These patients often have a frail status with multiple comorbidities which may complicate their postoperative course.Level of evidence level 4 case series.
特发性帕金森病（PD）患者骨折风险增加。目前，许多研究报告称 PD 患者在骨科手术后的结果较差。然而，很少有研究评估 PD 患者上肢骨折（UEF）的结果。在这项研究中，我们回顾了 40 例接受 UEF 手术治疗的 PD 患者。我们回顾性分析了在一家三级创伤中心接受 UEF 手术内固定治疗的 PD 患者。主要目的是确定手术固定后治疗失败的发生率。次要结果包括失败模式、治疗失败时间、住院时间、再入院率、再次手术率和术后并发症。共有 40 例 PD 患者（42 处骨折）接受了手术。最常见的骨折类型是桡骨骨折（n=19），其次是肱骨骨折（n=15）、掌骨/指骨骨折（n=5）、锁骨骨折（n=2）和尺骨鹰嘴骨折（n=1）。总的治疗失败率为 40.5%（n=17）。治疗失败时间为 1.24±3.1 个月，住院时间为 6±3.9 天，30 天内再入院率为 14%（n=6），再次手术率为 14%（n=6）。并发症发生率为 16.6%（n=7），肱骨骨折患者的住院时间似乎最长（6.6 天），并发症发生率也较高（13%，n=2）。尽管对 UEF 进行了手术固定，PD 患者的治疗失败率仍很高。这些患者通常身体虚弱，合并多种并发症，这可能会使他们的术后过程复杂化。证据等级为 4 级病例系列。
