Department of Orthopaedic Surgery and Traumatology, La Paz University Hospital, Paseo de la Castellana 261, Madrid, 28020, Spain.
Department of Orthopaedic Surgery and Traumatology, La Paz University Hospital, Paseo de la Castellana 261, Madrid, 28020, Spain.
Injury. 2021 Jul;52 Suppl 4:S71-S75. doi: 10.1016/j.injury.2021.03.066. Epub 2021 May 5.
the frequency of distal femur fractures in the elderly is rapidly increasing. A study of these fractures was conducted in our center in order to evaluate the comorbidities and the mortality associated with this entity.
all the distal femur fractures by low energy in patients over 65 years old at a tertiary center were included, between January 2010 and December 2016. Baseline characteristics, the type of fracture, comorbidities, and functional status before admission, were collected. The relationship of each of these variables to the final functional class, immediate and late complications and mortality during the follow-up. Fifty-nine patients were included, with a median age of 85.3 years (IQR 78.6-91.6). Fifty-one patients were women. In 10 patients, the fractures were atraumatic (postural change mainly in non-walking patients), and in 54 of the cases were treated surgically (6 with retrograde intramedullary nailing and 48 with lateral locking plate). The median time to surgery was 4.5 days (IQR 2-6) and 14 patients were operated within 48 hours. The median follow-up was 26.3 months.
fourteen patients died during the first year of follow-up. Factors independently associated with death during the first year after the fracture were: conservative treatment, and the inability to ambulate before the episode. The absence of certain comorbidities, such as chronic heart disease, and cancer, and an age under 80 years, behaved as protective factors.
low-energy distal femur fractures comprise a severe injury in the elderly and are associated with high mortality. Surgical treatment showed better outcomes in terms of survival, with no significant differences depending on the type of fracture, the type of implant or the median time to surgery.
老年人远端股骨骨折的频率正在迅速增加。我们在中心进行了这项研究，以评估与该疾病相关的合并症和死亡率。
在一家三级中心，我们纳入了所有年龄在 65 岁以上、因低能量导致的远端股骨骨折患者，时间为 2010 年 1 月至 2016 年 12 月。收集了患者的基本特征、骨折类型、合并症以及入院前的功能状态。研究了这些变量与最终功能分级、即刻和晚期并发症以及随访期间死亡率之间的关系。
共纳入 59 例患者，中位年龄为 85.3 岁（IQR 78.6-91.6）。51 例为女性。10 例患者的骨折为无创伤性（主要为非行走患者的体位改变），54 例患者接受了手术治疗（6 例采用逆行髓内钉治疗，48 例采用外侧锁定钢板治疗）。手术中位时间为 4.5 天（IQR 2-6），14 例患者在 48 小时内接受了手术。中位随访时间为 26.3 个月。
在随访的第一年，有 14 例患者死亡。与骨折后第一年死亡相关的独立因素为：保守治疗和骨折前无法行走。没有某些合并症（如慢性心脏病和癌症）和年龄小于 80 岁是保护因素。
低能量远端股骨骨折是老年人的严重损伤，与高死亡率相关。手术治疗在生存方面显示出更好的结果，与骨折类型、植入物类型或手术中位时间无关。
