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[动力髋螺钉或人工关节置换治疗老年股骨颈及股骨转子间骨折术后应激反应]

[Postoperative stress on by dynamic hip screw or endoprostheses treated femoral neck and pertrochanteric femoral fractures in elderly patients].

作者信息

Tucci M, Scharplatz D

机构信息

Chirurgische Abteilung, Spital Thusis.

出版信息

Swiss Surg. 1996(2):67-71.

PMID:8681111
Abstract

Fractures of the neck and the pertrochanteric region of the femur in elderly patients are often treated with dynamic hip screw or endoprothesis. In the aftercare, specially in fractures that have been stabilised with a DHS, partial weight-bearing is recommended. Some other authors describe immediate full weight-bearing after osteosynthesis with the same implant. For elderly patients it is often difficult to apply partial weight-bearing on one limb only. Remobilisation as soon as possible is very important to these patients, to avoid postoperative complications. Therefore the allowance of full weight-bearing enables us to rehabilitate these old patients more appropriate. We have studied the rates of systemic and local complications in patients with different weight bearing on the operated hip with means of the data of the ASIF-documentation records. In patients who bear full weight on the operated limb immediately after operation, the rates of systemic complications are lower. The rates of local complications increased with the instability of the fracture. Both results are though not statistically significant.

摘要

老年患者股骨颈和转子周围区域骨折常采用动力髋螺钉或人工关节置换治疗。在术后护理中,特别是对于采用动力髋螺钉固定的骨折,建议部分负重。其他一些作者描述了使用相同植入物进行骨合成后立即完全负重的情况。对于老年患者来说,仅单肢进行部分负重往往很困难。尽快恢复活动对这些患者非常重要,以避免术后并发症。因此,允许完全负重使我们能够更恰当地使这些老年患者康复。我们利用AO组织记录的数据研究了手术髋关节不同负重患者的全身和局部并发症发生率。术后立即在手术肢体上完全负重的患者,全身并发症发生率较低。局部并发症发生率随骨折不稳定性增加而升高。不过这两个结果均无统计学意义。

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