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对于 65 岁以上的单纯髋臼和骨盆环骨折患者,经皮螺钉固定后立即完全负重。

Immediate full weight bearing after pelvic percutaneous fixation by screw for simple acetabular and pelvic ring fractures in patients older than sixty five years.

机构信息

Centre Hospitalier Régional Universitaire Hôpitaux de Tours, 2 Boulevard Tonnellé, 37000, Tours, France.

Centre Hospitalier Régional Universitaire de Brest, Boulevard Tanguy Prigent, 29200, Brest, France.

出版信息

Int Orthop. 2022 Oct;46(10):2413-2421. doi: 10.1007/s00264-022-05504-z. Epub 2022 Jul 9.

DOI:10.1007/s00264-022-05504-z
PMID:35809129
Abstract

PURPOSE

The aim of this study was to assess the walking and weight-bearing abilities of patients older than 65 years with a simple acetabular or pelvic ring fracture treated with pelvic percutaneous screwing (PPS).

METHODS

This study included 27 patients. This was a retrospective, single-centre observational study conducted in a level 1 trauma centre from September 2019 to April 2021. All patients older than 65 years who underwent PPS for an acetabular or pelvic ring fracture were included.

RESULTS

All patients were able to walk and bear weight at one day after PPS. The mean walking distance increased from 19.4 m the day after the operation to 59.8 m, 497.8 m, and 1402 m at discharge, three and six weeks after the operation, respectively. The average pain visual analog scale scores before and after the operation were 4.1 (range, 3.6-5.1; standard deviation [SD], 0.63) and 0.9 (range, 0.5-1.2; SD, 0.25), respectively (p < .0001). The average daily dose of paracetamol used before and after the operation was 2.2 (range, 1.7-3.1; SD, 0.59) g/d and 1.3 (range, 0.6-1.7; SD, 0.40) g/d, respectively (p = .0232). The average daily dose of morphine used before and after the operation was 5.7 (range, 4.7-6.7; SD, 0.76) mg/d and 1.6 (range, 0.5-2.9; SD, 1.09) mg/d, respectively (p = .0001).

CONCLUSION

All included patients were able to walk at one day after PPS. PPS was associated with reduced pain as well as a reduction in paracetamol and morphine use.

摘要

目的

本研究旨在评估经皮骨盆螺钉固定(PPS)治疗 65 岁以上单纯髋臼或骨盆环骨折患者的行走和负重能力。

方法

本研究纳入 27 例患者。这是一项回顾性、单中心观察研究,于 2019 年 9 月至 2021 年 4 月在 1 级创伤中心进行。所有接受 PPS 治疗髋臼或骨盆环骨折且年龄大于 65 岁的患者均纳入本研究。

结果

所有患者在 PPS 后第 1 天即可行走和负重。术后第 1 天、出院时、术后 3 周、6 周的平均步行距离分别为 19.4m、59.8m、497.8m 和 1402m。术后和术前的平均疼痛视觉模拟评分分别为 4.1(范围:3.6-5.1;标准差 [SD]:0.63)和 0.9(范围:0.5-1.2;SD:0.25)(p<0.0001)。术后和术前的扑热息痛日平均剂量分别为 2.2(范围:1.7-3.1;SD:0.59)g/d 和 1.3(范围:0.6-1.7;SD:0.40)g/d(p=0.0232)。术后和术前的吗啡日平均剂量分别为 5.7(范围:4.7-6.7;SD:0.76)mg/d 和 1.6(范围:0.5-2.9;SD:1.09)mg/d(p=0.0001)。

结论

所有纳入的患者在 PPS 后第 1 天即可行走。PPS 可减轻疼痛,并减少扑热息痛和吗啡的使用。

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Operative versus non-operative treatment of displaced acetabular fractures in elderly patients.老年移位髋臼骨折的手术与非手术治疗。
Aging Clin Exp Res. 2020 Apr;32(4):571-577. doi: 10.1007/s40520-019-01231-5. Epub 2019 Jun 10.
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Percutaneous fixation of acetabular fractures.髋臼骨折的经皮固定术。
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