HEALING COMPLICATIONS AFTER INTERNAL-FIXATION OF TROCHANTERIC HIP-FRACTURES - THE PROGNOSTIC VALUE OF OSTEOPOROSIS
HEALING COMPLICATIONS AFTER INTERNAL-FIXATION OF TROCHANTERIC HIP-FRACTURES - THE PROGNOSTIC VALUE OF OSTEOPOROSIS
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DOI：
10.1097/00005131-199310000-00006
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发表时间：
1993-10-01
影响因子：
2.3
通讯作者：
WALHEIM, G
中科院分区：
文献类型：
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作者：
BARRIOS, C;BROSTROM, LA;WALHEIM, G
在一项为期3年的前瞻性随机试验中，对113例采用滑动螺钉接骨板或Ender钉治疗的股骨转子间骨折患者进行了研究，探讨了骨质疏松症在预测因植入物失效或骨折复位丢失导致的愈合并发症方面的预后价值。根据Barnet和Nordin的骨质疏松指数，66例患者被认为是中度或重度骨质疏松症。患有或不患有骨质疏松症的患者之间，内翻塌陷>10度、再脱位>10 mm或压缩超过10 mm的骨折数量没有差异。手术后六个月，48名患者未能愈合或愈合后出现并发症。这些病例显示骨质疏松症的增加与那些显示非复杂性愈合。发现采用Ender钉治疗的不稳定性骨折的骨质疏松患者的愈合并发症预后最差（p = 0.006）。在33例植入物失效的骨折中，25例（76%）发生在骨质疏松症患者中（p = 0.04）。在骨质疏松症患者中，器械定位不正确的骨折机械故障频率显著更高。与所用器械无关，不稳定性股骨转子骨折和骨质疏松患者是植入物失效风险最高的患者。
In a 3-year prospective randomized trial, the prognostic value of osteoporosis in terms of predicting healing complications due to implant failures or loss of fracture reduction has been studied in 113 patients with intertrochanteric hip fractures treated with either a sliding screwplate or Ender nailing. According to the Barnet and Nordin's osteoporosis index, 66 patients were considered to have moderate or severe osteoporosis. There were no differences between patients with or without osteoporosis as regards the number of fractures with collapse in varus >10-degrees, redislocation >10 mm, or compression exceeding 10 mm. Six months after surgery, 48 patients failed in healing or healed with complications. These cases disclosed increased osteoporosis in comparison with those showing noncomplicated healing. Patients with osteoporosis who had unstable fractures treated by Ender nailing were found to have the worst prognosis for healing complications (p = 0.006). Of the 33 fractures with implant failures, 25 (76%) occurred in patients with osteoporosis (p = 0.04). In patients with osteoporosis, the frequency of mechanical failures was significantly higher in fractures with the device positioned incorrectly. Independently of the device used, patients with unstable trochanteric hip fractures and osteoporotic bone were the group with the highest risk for failures of the implant.