后路全髋关节置换术治疗移位性髋囊内骨折的死亡率和并发症:来自区域创伤中心的结果。

The Ulster medical journal Pub Date : 2024-12-01 Epub Date: 2024-12-11
Grace Em Kennedy, Julie Craig, Samuel E McMahon, Laurence A Cusick
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引用次数: 0

摘要

全髋关节置换术(THA)治疗髋关节囊内移位骨折越来越普遍。该项目的目的是确定全因死亡率、严重并发症发生率和骨折THA后的功能结局。方法:通过住院患者数据库检索,确定了2010-2017年北爱尔兰区域创伤中心所有因移位性囊内骨折接受THA治疗的患者。审查了区域电子医疗保健系统以寻找并发症的证据。结果:经排除后,共发现345例。中位年龄为70岁(31 ~ 91岁)。中位随访时间为4.3年(1.6 - 9.3年)。30天全因死亡率为0.3%,1年3.2%,2年5.5%。7例(2.0%)发生脱位。大多数发生在60天内;5例患者接受了翻修。48例(13.8%)患者出现异位骨化(HO)的影像学证据。再次手术16例(4.6%)。其中包括5例脱位,8例假体周围骨折(7例),2例感染和1例症状性HO。损伤前,96.2%(332/345)患者能独立活动,1年后78.9%(262/332)患者仍能独立活动。损伤前,96.2%获得最高功能评分(Barthel指数,最高评分为20),一年后78.9%(262/332)的患者继续报告最高Barthel指数评分。结论:髋关节置换术治疗髋部骨折的脱位风险为2.0%,再手术风险为4.6%。HO是常见的,但很少需要再次手术。全因死亡率和功能水平与当前文献相比有利。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Mortality and complications after total hip arthroplasty via the posterior approach for displaced intracapsular hip fracture: Results from a regional trauma centre.

Introduction: Total hip arthroplasty (THA) for displaced intracapsular hip fracture is increasingly common. The aim of this project was to determine all-cause mortality rates, rates of significant complications and functional outcomes following THA for fractures.

Methods: An inpatient database search identified all patients undergoing THA for displaced intracapsular fracture in Northern Ireland's regional trauma centre from 2010-2017. Regional electronic healthcare systems were reviewed for evidence of complications.

Results: After exclusions, 345 cases were identified. The median age was 70 years (31 - 91 years).Median follow-up was 4.3 years (1.6 - 9.3 years). The all-cause mortality rate was 0.3% at 30 days, 3.2% at one year, and 5.5% at two years.Seven patients (2.0%) experienced dislocations. Most occurred within 60 days; five patients underwent revision.Radiographic evidence of heterotopic ossification (HO) was seen in 48 patients (13.8%).Re-operation was required for 16 patients (4.6%). This included 5 dislocations, eight cases of periprosthetic fractures (in seven patients), two cases of infection, and one case of symptomatic HO.Pre-injury, 96.2% (332/345) were independently mobile, and after one year 78.9% (262/332) of those patients remained so. Pre-injury, 96.2% obtained the maximum functional score (Barthel Index, maximum score of 20), and after one year 78.9% (262/332) of these continued to report a maximum Barthel Index score.

Conclusion: THA for hip fracture holds a 2.0% risk of dislocation and a 4.6% risk of re-operation. HO is common but seldom requires re-operation. All-cause mortality rates and functional levels compared favourably with current literature.

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