Koval K J, Friend K D, Aharonoff G B, Zukerman J D
Department of Orthopaedic Surgery, Hospital for Joint Diseases Orthopaedic Institute, New York, NY 10003, USA.
J Orthop Trauma. 1996;10(8):526-30. doi: 10.1097/00005131-199611000-00003.
Five hundred ninety-six patients age > or = 65 with femoral neck or intertrochanteric fractures were allowed immediate unrestricted weight bearing after surgery and were prospectively followed. Follow-up data and hospital records were examined to identify those patients who required additional hip surgery owing to failure of fixation, nonunion, osteonecrosis, or prosthetic dislocation. Four hundred seventy-three patients were available for 1-year minimum follow-up; 16 patients (3.4%) required additional hip surgery. The revision surgery rate after intertrochanteric fracture due to loss of fixation was 2.9%. The revision surgery rate after internal fixation of the femoral neck from loss of fixation/nonunion was 5.3%; the revision rate from osteonecrosis for patients with 2-year follow-up was 5.4%. The revision rate after hemiarthroplasty due to prosthetic dislocation was 0.6%. These results support the use of unrestricted weight bearing in elderly patients after hip fracture surgery.
596例年龄大于或等于65岁的股骨颈或转子间骨折患者术后立即允许不受限制地负重，并进行前瞻性随访。检查随访数据和医院记录，以确定那些因内固定失败、骨不连、骨坏死或假体脱位而需要再次进行髋关节手术的患者。473例患者至少随访1年；16例患者（3.4%）需要再次进行髋关节手术。转子间骨折后因内固定失败导致的翻修手术率为2.9%。股骨颈内固定后因内固定失败/骨不连导致的翻修手术率为5.3%；2年随访患者因骨坏死导致的翻修率为5.4%。半髋关节置换术后因假体脱位导致的翻修率为0.6%。这些结果支持髋部骨折手术后老年患者不受限制地负重使用。
