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老年股骨颈骨折患者行半髋关节置换术的手术治疗后的死亡率及功能预后

Mortality and functional outcomes in elderly adults treated surgically by hemiarthroplasty for femoral neck fractures.

作者信息

Ratanpal Ankush, Kamath Katapadi Ramachandra, Salian Preetham Raj V, Baliga Saiprasad Sarvothama, Annappa Rajendra, Banerjee Sayak

机构信息

North DMC Medical College and Hindu Rao Hospital, Guru Gobind Singh Indraprastha University, Delhi, India.

Department of Orthopaedics, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Karnataka, Manipal, India.

出版信息

SAGE Open Med. 2025 Jan 9;13:20503121241307264. doi: 10.1177/20503121241307264. eCollection 2025.

Abstract

BACKGROUND

Despite multiple studies, less recent literature and data regarding the mortality associated with hip fractures in the elderly population are available.

OBJECTIVES

To assess the mortality data and functional outcomes of patients who underwent cemented and uncemented hemiarthroplasty in femoral neck fractures. To evaluate if preoperative (minimum 2 months) calcium and vitamin D supplement intake in patients affects postoperative mobilization with or without walker support.

METHODS

All patients aged 65 and above who underwent hemiarthroplasty for femoral neck fractures in our tertiary care center were included. Postoperative functional outcomes were determined using the Modified Harris Hip score and Oxford Hip score at 3, 6, and 12 months. The mortality of the procedures was assessed at 3, 6, and 12 months. Individuals who took both calcium and vitamin D supplements for at least 2 months before surgery were divided into two groups: those who did not take supplements and those who did.

RESULTS

We studied 110 patients above the age of 65 years. The postoperative mortality rate at 3, 6 months and 1 year postoperatively was found to be 3.6%, 4.7%, and 15.5% respectively. Functional outcomes were assessed at 3, 6, and 12 months postoperatively using modified Harris Hip score and Oxford Hip score and were found to be identical in both cemented and uncemented hemiarthroplasty groups. Patients who took calcium and vitamin D supplements preoperatively (minimum 2 months) could walk without support at the end of 1-year post-surgery.

CONCLUSION

Early surgery and early mobilization should be the main aim of treatment for femoral neck fractures.

摘要

背景

尽管有多项研究,但关于老年人群髋部骨折相关死亡率的近期文献和数据较少。

目的

评估股骨颈骨折行骨水泥型和非骨水泥型半髋关节置换术患者的死亡率数据和功能结局。评估患者术前(至少2个月)摄入钙和维生素D补充剂是否会影响术后在有或无助行器支持下的活动能力。

方法

纳入在我们三级医疗中心接受股骨颈骨折半髋关节置换术的所有65岁及以上患者。在术后3、6和12个月使用改良Harris髋关节评分和牛津髋关节评分确定术后功能结局。在术后3、6和12个月评估手术的死亡率。术前至少2个月同时服用钙和维生素D补充剂的个体分为两组:未服用补充剂组和服用补充剂组。

结果

我们研究了110名65岁以上的患者。术后3个月、6个月和1年的术后死亡率分别为3.6%、4.7%和15.5%。术后3、6和12个月使用改良Harris髋关节评分和牛津髋关节评分评估功能结局,发现骨水泥型和非骨水泥型半髋关节置换术组的功能结局相同。术前(至少2个月)服用钙和维生素D补充剂的患者在术后1年末可以无需支持行走。

结论

早期手术和早期活动应是股骨颈骨折治疗的主要目标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f871/11713951/728233ee25a1/10.1177_20503121241307264-fig1.jpg

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