双活动杯直接前路全髋关节置换术治疗痴呆患者股骨颈骨折。

IF 1.8 Q2 ORTHOPEDICS
SICOT-J Pub Date : 2025-01-01 Epub Date: 2025-07-16 DOI:10.1051/sicotj/2025034
Ryuji Okuno, Tomonori Baba, Yu Ozaki, Yasuhiro Homma, Kazuo Kaneko, Muneaki Ishijima
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引用次数: 0

摘要

背景:股骨颈骨折(FNFs)痴呆患者无法理解其脱位的肢体定位,这可能会影响康复,导致功能恢复较差。最近,使用双活动杯(DMC)治疗移位的fnf的直接前路全髋关节置换术(DAA-THA)取得了良好的临床结果。本研究旨在探讨有痴呆和无痴呆患者移位fnf的THA临床结果的差异。方法:本研究为回顾性研究,纳入151例行DAA-THA联合DMC治疗移位的fnf的患者。损伤前诊断为痴呆的患者分为痴呆组(43例)和非痴呆对照组(对照组,108例)。评估项目为年龄、性别、体重指数(BMI)、术前骨折活动能力评分(FMS)、等待时间、术前麻醉评估、出血量、手术时间、并发症、术后1年死亡率、术后1年FMS。FMS评分为:单独行走:1分,拐杖行走:2分,助行器行走:3分,手导行走:4分,轮椅行走:5分。结果:两组患者年龄、体重、BMI、手术时间差异均有统计学意义。两组术后均未见脱位。比较损伤前后的FMS分为三类:(1)与损伤前相比没有变化;(2)下降一级;(3)下降二级以上。在这些类别中均未发现显著差异(p = 0.09)。功能结果显示活动能力恢复无显著差异。1年死亡率为9.35%(16例),两组间差异无统计学意义(p = 0.17)。讨论:DAA-THA使用DMC治疗移位的fnf可能具有相似的功能结局和死亡率,无论是痴呆患者还是非痴呆患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Direct anterior total hip arthroplasty with dual mobility cup for femoral neck fractures in dementia patients.

Background: Dementia patients with femoral neck fractures (FNFs) are unable to understand their dislocated limb positioning, which may impair rehabilitation and result in poorer functional recovery. Recently, good clinical results have been reported for the direct anterior approach for total hip arthroplasty (DAA-THA) using a dual mobility cup (DMC) for displaced FNFs. This study aimed to investigate differences in the clinical outcome of THA for displaced FNFs in patients with and without dementia.

Methods: This study was retrospective and included 151 patients who underwent DAA-THA with DMC for displaced FNFs. Patients diagnosed with dementia prior to injury were classified into a dementia group (43 patients) and a non-dementia control group (control group, 108 patients). The evaluation items were age, sex, body mass index (BMI), preoperative Fracture Mobility Score (FMS), waiting period, preoperative anesthetic assessment, blood loss, operation time, complications, 1-year mortality, and 1-year FMS after surgery. The FMS was scored as: walking alone: 1, walking with a cane: 2, walking with a walker: 3, hand-guided walking: 4, and wheelchair: 5.

Results: Significant differences were found in age, weight, BMI, and operation time. Postoperative dislocation was not observed in both groups. FMS was compared before and after injury in three categories: (1) unchanged from before injury, (2) one rank down, and (3) two or more ranks down. No significant differences were found in any of these categories (p = 0.09). Functional outcomes showed no significant difference in mobility recovery. The 1-year mortality rate was 9.35% (16 patients), with no significant difference between the two groups (p = 0.17).

Discussion: DAA-THA using DMC for displaced FNFs may have similar functional outcomes and mortality rates in both patients with and without dementia.

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来源期刊
SICOT-J
SICOT-J ORTHOPEDICS-
CiteScore
3.20
自引率
12.50%
发文量
44
审稿时长
14 weeks
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