Koval K J, Sala D A, Kummer F J, Zuckerman J D
Department of Orthopaedic Surgery, Hospital for Joint Diseases, New York City, NY 10003, USA.
J Bone Joint Surg Am. 1998 Mar;80(3):352-6. doi: 10.2106/00004623-199803000-00007.
Sixty patients who had had operative treatment of a fracture of the femoral neck or an intertrochanteric fracture were allowed to bear weight as tolerated on the injured limb. The average age was seventy-seven years. Computerized gait-testing was performed at one, two, three, six, and twelve weeks postoperatively to quantify weight-bearing. For the purpose of analysis, the patients were divided into three groups according to whether they had internal fixation of a stable fracture, internal fixation of an unstable fracture, or a primary hemiarthroplasty. Thirty-two patients completed the entire twelve-week study. The average amount of weight that these patients placed on the injured limb increased progressively with time. The average load supported by the injured limb was 51 per cent that of the uninjured limb at one week, and it gradually increased to 87 per cent at twelve weeks. During the first three weeks, the patients who had had internal fixation bore substantially less weight than those who had had a hemiarthroplasty. By six weeks, we could detect no significant differences, with the numbers available, among the groups with regard to weight-bearing or other measured gait parameters. We concluded that elderly patients who are allowed to bear weight as tolerated after operative treatment of a fracture of the femoral neck or an intertrochanteric fracture appear to voluntarily limit loading of the injured limb.
六十例接受股骨颈骨折或转子间骨折手术治疗的患者，在耐受范围内允许受伤肢体负重。平均年龄为77岁。术后1周、2周、3周、6周和12周进行计算机化步态测试以量化负重情况。为便于分析，根据患者接受的是稳定骨折内固定、不稳定骨折内固定还是初次半髋关节置换术，将患者分为三组。32例患者完成了整个为期12周的研究。这些患者受伤肢体的平均负重随着时间的推移逐渐增加。受伤肢体在术后1周时所承受的平均负荷为未受伤肢体的51%，并在12周时逐渐增至87%。在最初的三周内，接受内固定的患者所承受的重量明显低于接受半髋关节置换术的患者。到6周时，就现有数据而言，各组在负重或其他测量的步态参数方面未发现显著差异。我们得出结论，在接受股骨颈骨折或转子间骨折手术治疗后在耐受范围内负重的老年患者，似乎会主动限制受伤肢体的负荷。
