接受关节置换术治疗的老年股骨颈移位骨折患者的活动能力和髋关节功能
Mobility and Hip Function Among Geriatric Patients With Displaced Neck of Femur Fractures Treated With Arthroplasty.
作者信息
Ho Jade Pei Yuik, Wong Amy Yoke Foong, Ong Lik Han, Rutel Ankimtay, Abdullah Sabaruddin, Jaffar Mohd Shahrul Azuan, Bong Chun Haw, Tan Kean Tee, Rao Reuben Prashant, Kamaruddin Faris
机构信息
Department of Orthopaedic Surgery, Sarawak General Hospital, Ministry of Health Malaysia.
Department of Orthopaedic Surgery, Universiti Malaysia Sarawak, Kota Samarahan, Malaysia.
出版信息
Geriatr Orthop Surg Rehabil. 2023 Mar 10;14:21514593231164245. doi: 10.1177/21514593231164245. eCollection 2023.
BACKGROUND
Neck of femur fractures result in impaired function for older people. Despite surgery, many patients experience a decrease in functional level and poorer health status after the injury. The objectives of this study were (1) to determine the short-term mobility and hip function of geriatric patients who underwent hip replacement surgery for a displaced neck of femur fracture in our local population and (2) to identify factors which affect the functional outcome of these patients.
METHODS
Patients aged 60 years and above, who were admitted for neck of femur fracture from January 2017 to December 2020, and treated surgically with arthroplasty, were included. Information on patient demography, comorbidities, perioperative data, mobility, hip function and complications were retrospectively collected. Outcome measures used were independent ambulation and recovery of pre-fracture mobility at 1 year after surgery while hip function was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total, pain, stiffness, and physical function scores. Factors associated with these outcomes were analyzed.
RESULTS
168 patients with a mean age of 75.2 (SD 8.4) years met the inclusion criteria. 32.1% of patients regained their pre-fracture mobility and 59.6% remained independent 1 year after surgery. Logistic regression analysis identified age, gender, surgical procedure, and time to surgery as significant contributors to recovery of pre-fracture mobility. Older age and increasing requirement for postoperative ambulatory aid resulted in worse WOMAC total and physical function scores. No significant differences were observed in patient-reported hip function between those who had a total hip arthroplasty and those who had a hemiarthroplasty.
CONCLUSION
Most geriatric patients with displaced neck of femur fractures did not regain pre-fracture mobility despite surgical treatment with arthroplasty.
背景
股骨颈骨折会导致老年人功能受损。尽管进行了手术，但许多患者在受伤后功能水平下降，健康状况更差。本研究的目的是：（1）确定在我们当地人群中因股骨颈移位骨折接受髋关节置换手术的老年患者的短期活动能力和髋关节功能；（2）确定影响这些患者功能结局的因素。
方法
纳入2017年1月至2020年12月因股骨颈骨折入院并接受关节置换手术治疗的60岁及以上患者。回顾性收集患者人口统计学、合并症、围手术期数据、活动能力、髋关节功能和并发症等信息。使用的结局指标为术后1年独立行走及恢复骨折前活动能力，同时使用西安大略和麦克马斯特大学骨关节炎指数（WOMAC）总分、疼痛、僵硬及身体功能评分评估髋关节功能。分析与这些结局相关的因素。
结果
168例平均年龄为75.2（标准差8.4）岁的患者符合纳入标准。32.1%的患者术后1年恢复了骨折前的活动能力，59.6%的患者仍能独立活动。逻辑回归分析确定年龄、性别、手术方式和手术时间是骨折前活动能力恢复的重要影响因素。年龄越大，术后行走辅助需求增加，WOMAC总分及身体功能评分越差。全髋关节置换术患者与半髋关节置换术患者在患者报告的髋关节功能方面未观察到显著差异。
结论
尽管采用关节置换术进行手术治疗，但大多数股骨颈移位骨折的老年患者并未恢复骨折前的活动能力。
Zotero 插件