Malkin S, Frankenburg F
J Am Geriatr Soc. 1978 Nov;26(11):506-9. doi: 10.1111/j.1532-5415.1978.tb03334.x.
Records were reviewed on 445 patients with fracture of the hip admitted to St. Paul's Hospital, Vancouver, Canada, during the period 1973--1975 inclusive. The epidemiologic factors were analyzed: age, sex, where and when the accident occurred, site of the fracture, the treatment procedure, length of time in hospital, complications, associated conditions, and final placement of the patient. Of the patients, 286 (64 percent) were more than 70 years of age. Among the 260 causal accidents in the patients' home living space or in the hospital, 35 involved toileting. The great majority of the fractured hips (330) were treated by open operation and internal fixation with the Pugh nail; the remainder were treated by conservative methods, various other devices, or arthroplasty. Within 30 days, 121 patients were discharged to their own homes and 68 to a major rehabilitation hospital. A total of 289 patients eventually returned to their own homes. The Pugh nail method of fixation permits early physiotherapy and early walking exercises, beginning within the first few days postoperatively. This largely accounts for the low complication rate, rapid achievement of functional status, and reduced hospital stay. Among the 445 patients there were 43 deaths, including 10 which occurred before operation could be undertaken.
对1973年至1975年（含）期间入住加拿大温哥华圣保罗医院的445例髋部骨折患者的病历进行了回顾。分析了流行病学因素：年龄、性别、事故发生的地点和时间、骨折部位、治疗方法、住院时间、并发症、相关疾病以及患者的最终安置情况。在这些患者中，286例（64%）年龄超过70岁。在患者家中居住空间或医院发生的260起意外事故中，35起与如厕有关。绝大多数髋部骨折（330例）采用开放手术并用普格钉内固定治疗；其余患者采用保守方法、其他各种器械或关节成形术治疗。30天内，121例患者出院回家，68例转入大型康复医院。共有289例患者最终回到家中。普格钉固定法允许在术后头几天内尽早进行物理治疗和早期步行锻炼。这在很大程度上解释了并发症发生率低、功能状态恢复快和住院时间缩短的原因。在445例患者中，有43例死亡，其中10例在手术前死亡。
