Displaced intracapsular neck of femur fractures in the elderly: Bipolar hemiarthroplasty may be the treatment of choice; a case control study
Displaced intracapsular neck of femur fractures in the elderly: Bipolar hemiarthroplasty may be the treatment of choice; a case control study
复制标题
DOI：
10.1016/j.injury.2015.06.047
复制
发表时间：
2015-10-01
影响因子：
2.5
通讯作者：
Middleton, R. G.
中科院分区：
文献类型：
--
作者：
Jonas, S. C.;Shah, R.;Middleton, R. G.
管理活动的老年患者谁维持一个囊内颈股骨骨折仍然存在争议。全髋关节置换术（THA）具有较高的手术和脱位风险，但与双极半关节置换术相比，THA在功能和再手术率方面是否明显优于THA，目前的证据不一。110例囊内非of骨折患者接受了全髋关节置换术或双相半关节置换术，随访时仍存活，回顾性鉴定并使用国家髋部骨折数据库进行匹配。匹配标准包括ASA、年龄、性别、术前活动能力、术前AMTS和入院来源。通过邮寄问卷进行随访。两组平均随访时间为24个月（范围：双相12-36个月，THA 12-38个月）。两组术前Tonnis评分、术后牛津髋关节评分（OHS）和SF-36评分均无显著差异。全髋关节置换术组5例患者发生12位脱位，双相情感障碍组无脱位。33/55双相患者出院回家，而THA组为35/55。双相半关节置换术没有一例改为全髋关节置换术。THA组并发症发生率较高，但功能未见改善。(C) 2015 Elsevier Ltd.版权所有。
Management of the mobile elderly patient who sustains an intra-capsular neck of femur fracture remains controversial. Current evidence is mixed as to whether total hip arthroplasty (THA), which confers higher surgical and dislocation risk, is significantly superior in function and in reduced rates of reoperation when compared to bipolar hemi-arthroplasty.A group of 110 patients with an intra-capsular NOF fracture who had undergone either THA or Bipolar hemi-arthroplasty and were still alive at the time of follow up were retrospectively identified and matched using the National Hip Fracture Database. Matching criteria included ASA, age, sex, pre-op mobility, pre-op AMTS and source of admission. Follow up was by postal questionnaire.Mean follow up was 24 months in both groups (Range; Bipolar 12-36 months, THA 12-38 months). There was no significant difference in pre-operative Tonnis grade, postoperative Oxford Hip Score (OHS) or Short Form 36 (SF-36) scores between the two groups. 12 dislocations in 5 patients occurred in the THA group and none in the bipolar group. 33/55 Bipolar patients were discharged to their own home compared to 35/55 in the THA group. None of the bipolar hemi-arthroplasties were revised to THA.Higher complication rates were experienced in the THA group with no increase in function. (C) 2015 Elsevier Ltd. All rights reserved.