Better Prognosis of Senile Patients with Intertrochanteric Femoral Fracture by Treatment with Open Reduction Internal Fixation than by Hip Arthroplasty
Better Prognosis of Senile Patients with Intertrochanteric Femoral Fracture by Treatment with Open Reduction Internal Fixation than by Hip Arthroplasty
复制标题
切开复位内固定治疗老年股骨粗隆间骨折患者预后优于人工髋关节置换术
DOI：
10.1080/08941939.2017.1333177
复制
发表时间：
2018-01-01
影响因子：
1.9
通讯作者：
Kang, Yan
中科院分区：
文献类型：
--
作者：
Yang, Zi-Bo;Wu, Pei-Hui;Kang, Yan
目的：比较接受切开复位内固定（ORIF）或髋关节置换术的股骨粗隆间骨折（IFF）患者的术后生存率和死亡率。方法：回顾性分析老年股骨颈骨折患者行切开复位内固定术或人工髋关节置换术的临床资料。采用Kaplan-Meier法和log-rank检验比较各组生存曲线。考克斯多因素回归分析确定影响预后的重要因素。结果：所有患者术后均痊愈。虽然31名患者在随访期间死亡（ORIF，平均45.4个月;关节成形术，平均51.6个月），但两组之间的死亡率无显著差异。ORIF组的1年和2年生存率估计值分别为92.2%和86%;关节成形术组分别为85%和74%。ORIF组和关节成形术组的平均生存期分别为88和67个月。手术入路对生存率的影响差异显著（对数秩检验c2 = 6.402，p = 0.011）。多因素考克斯回归模型显示，手术选择（p = 0.036）是老年IFF预后的重要独立危险因素，即使调整了年龄（p = 0.002）。结论：ORIF治疗老年IFF患者术后总体预后上级。
Purpose: To compare the postoperative survival and mortality rates in intertrochanteric femoral fracture (IFF) patients who underwent either open reduction internal fixation (ORIF) or hip arthroplasty. Methods: Clinical data from senior patients who had IFF and underwent ORIF or hip arthroplasty were analyzed retrospectively. Survival curves were compared between groups with Kaplan-Meier method and log-rank test. Significant independent prognostic factors were identified by Cox multivariate regression analysis. Results: All patients recovered fully post-surgery. Although 31 patients died during the follow-up period (ORIF, mean 45.4months; arthroplasty, mean 51.6months), mortality rate did not differ significantly between the groups. The 1-yr and 2-yr survival rate estimates for the ORIF group were 92.2%, and 86%, respectively; they were 85% and 74% for the arthroplasty group. Average survival lengths for ORIF and arthroplasty groups were 88 and 67months, respectively. The effect of surgical approaches on survival differed significantly (log-rank test c2 = 6.402, p = 0.011). Multivariate Cox regression model indicated that surgical choice (p = 0.036) was a significant independent risk factor for the prognosis of senile IFF, even with adjustment for age (p = 0.002). Conclusion: The overall postoperative prognosis was superior in senile IFF patients treated with ORIF.