Strömqvist B, Kelly I, Lidgren L
Department of Orthopaedics, University Hospital, Lund, Sweden.
Clin Orthop Relat Res. 1988 Mar(228):75-8.
Of 1100 femoral neck fractures observed through an eight-year period, 27 occurred in rheumatoid conditions. The complications and functional results were compared with unselected femoral neck fracture data of nonrheumatoid patients. At two-year follow-up examinations, five of 27 surviving rheumatoid patients had had undisplaced fractures; one of the five developed segmental femoral head collapse. Nineteen of 20 patients with displaced fractures lost position or developed non-union or segmental femoral head collapse; 14 required total hip arthroplasty. In the control non-rheumatoid group, six of 27 undisplaced fractures and 34 of 67 displaced fractures developed complications. In displaced fractures, complications occurred more often in rheumatoid patients (p less than 0.0004). Because in rheumatoid patients internal fixation in displaced fractures is associated with an unacceptably high failure rate, primary hip arthroplasty may prove to be the procedure of choice.
在八年期间观察到的1100例股骨颈骨折中，有27例发生于类风湿病患者。将这些患者的并发症和功能结果与非类风湿病患者未经过挑选的股骨颈骨折数据进行了比较。在两年的随访检查中，27名存活的类风湿病患者中有5例为无移位骨折；这5例中有1例发生了股骨头节段性塌陷。20例移位骨折患者中有19例出现了骨折移位、骨不连或股骨头节段性塌陷；其中14例需要进行全髋关节置换术。在对照的非类风湿病组中，27例无移位骨折中有6例以及67例移位骨折中有34例出现了并发症。在移位骨折中，类风湿病患者发生并发症的情况更为常见（p<0.0004）。由于在类风湿病患者中，移位骨折进行内固定的失败率高得令人难以接受，因此初次髋关节置换术可能是首选的治疗方法。
