Yu Shujun, Li Chen, Zhong Yuqiao, Zang Jiacheng, Zhou Zhanzhe, Wang Song, Zhang Yinguang
The First Department of Hip Traumatology, Tianjin Hospital, Tianjin, China.
Department of Radiology, Tianjin Hospital, Tianjin, China.
Front Surg. 2022 Sep 13;9:924585. doi: 10.3389/fsurg.2022.924585. eCollection 2022.
The purpose of this study was to identify which of the risk factors would contribute to the contralateral fracture in very elderly patients after intramedullary nail fixation.
Clinical data of 227 intertrochanteric fracture patients aged 80 years or older were retrospectively reviewed. Intramedullary nails (IMNs) were used on all of the patients. Potential risk factors for contralateral hip refractures were determined using univariate and logistic regression analyses.
Contralateral hip refractures occurred in 11 patients (4.84%). Univariate analysis revealed that age, gender, body mass index, fracture classification, hematocrit, D-dimer, and CRP level were not associated with contralateral fractures (> 0.05). However, neurological diseases, cardiovascular disease, and visual impairments were significantly associated with contralateral fractures (< 0.05). Multivariate analysis further revealed that neurological diseases (OR 4.25, = 0.044) and visual impairments (OR 5.42, = 0.015) were independent risk factors associated with contralateral refractures.
To prevent contralateral refractures, more attention should be paid to elderly intertrochanteric fracture patients with underlying neurological disease and visual impairments.
本研究旨在确定哪些风险因素会导致高龄患者髓内钉固定术后对侧骨折。
回顾性分析227例80岁及以上股骨转子间骨折患者的临床资料。所有患者均采用髓内钉（IMN）治疗。采用单因素分析和逻辑回归分析确定对侧髋部骨折的潜在风险因素。
11例患者（4.84%）发生对侧髋部骨折。单因素分析显示，年龄、性别、体重指数、骨折分型、血细胞比容、D-二聚体及CRP水平与对侧骨折无关（>0.05）。然而，神经系统疾病、心血管疾病及视力障碍与对侧骨折显著相关（<0.05）。多因素分析进一步显示，神经系统疾病（OR 4.25，=0.044）及视力障碍（OR 5.42，=0.015）是对侧骨折的独立危险因素。
为预防对侧骨折，对于合并神经系统疾病及视力障碍的老年股骨转子间骨折患者应给予更多关注。
