Routledge Jamie C, Bashir Oladimeji, Elbeshbeshy Mohamed, Saber Ahmed Y, Aqil Adeel
Orthopaedics and Trauma, Huddersfield Royal Infirmary, Huddersfield, GBR.
Cureus. 2023 Sep 16;15(9):e45333. doi: 10.7759/cureus.45333. eCollection 2023 Sep.
Distal femur fractures are a frequently encountered injury, especially among the ageing population. Previous studies have identified that these fractures can be managed with a variety of methods and techniques which has led to an ongoing debate and investigation to decipher the optimal approach to manage these fractures.
The purpose of this study was to compare outcomes of patients managed with either distal femur replacements (DFRs), surgical fixation (SF) or conservative management. Outcomes measured included length of hospital stay, readmission rates, 30-day mortality and Oxford Knee Score.
A retrospective review was conducted, of patients admitted with distal femur fractures between June 2020 and October 2022 at Huddersfield Royal Infirmary Hospital. Patients with both native and peri-prosthetic joints were included. All patient's medical data, including imaging and operative records, were reviewed.
A total of 42 patients were identified. There were six males and 36 females with a mean age of 78 years, a median age of 76 and a range of 35-102 years. Of these fractures, 15 were peri-prosthetic, and 27 were native joints. Of the patients, 30 had an SF, five had a DFR and the remaining seven were conservatively managed. Those managed with an SF had an average length of stay of 18 days, an Oxford score of 24 and two patients were readmitted within 30 days of discharge. For the DFR, the average length of stay was 16 days, an Oxford score of 22 and no patients were readmitted within 30 days. For the conservatively managed patients 21 days, an Oxford score of 25 and two patients were readmitted within 30 days of discharge. There was no 30-day mortality across all groups.
From our study, we can conclude that patients who managed with a DFR had the shortest length of stay in a hospital and the lowest readmission rates when compared to alternative management techniques. There was minimal difference found between the Oxford scores between all three groups. This study shows that DFR can be a safe and reliable strategy to manage distal femur fractures. Additional research is required to further compare the outcomes of these different methods of repair.
股骨远端骨折是一种常见的损伤，在老年人群中尤为常见。以往的研究表明，这些骨折可以通过多种方法和技术进行治疗，这引发了一场关于如何确定最佳治疗方法的持续争论和研究。
本研究的目的是比较接受股骨远端置换术（DFR）、手术固定（SF）或保守治疗的患者的治疗效果。测量的结果包括住院时间、再入院率、30天死亡率和牛津膝关节评分。
对2020年6月至2022年10月在哈德斯菲尔德皇家医院收治的股骨远端骨折患者进行回顾性研究。纳入了原发性和假体周围关节骨折的患者。对所有患者的医疗数据，包括影像学和手术记录进行了审查。
共确定了42例患者。其中男性6例，女性36例，平均年龄78岁，中位数年龄76岁，年龄范围为35至102岁。这些骨折中，15例为假体周围骨折，27例为原发性关节骨折。在这些患者中，30例接受了手术固定，5例接受了股骨远端置换术，其余7例接受了保守治疗。接受手术固定的患者平均住院时间为18天，牛津评分为24分，2例患者在出院后30天内再次入院。对于股骨远端置换术，平均住院时间为16天，牛津评分为22分，30天内无患者再次入院。对于保守治疗的患者，住院时间为21天，牛津评分为25分，2例患者在出院后30天内再次入院。所有组均无30天死亡率。
从我们的研究中可以得出结论，与其他治疗技术相比，接受股骨远端置换术的患者住院时间最短，再入院率最低。三组之间的牛津评分差异最小。本研究表明，股骨远端置换术可以是治疗股骨远端骨折的一种安全可靠的策略。需要进一步的研究来进一步比较这些不同修复方法的效果。
