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老年股骨近端骨折髋关节置换术后发生对侧骨折的原因分析

Risk factors of contralateral fractures after hip replacement in elderly patients with proximal femur fractures

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【作者】 来红徐灿达汤样华

【Author】 LAI Hong;XU Canda;TANG Yanghua;Department of Orthopedics, Xiaoshan TCM Hospital,Hangzhou;

【通讯作者】 来红;

【机构】 杭州市萧山区中医院骨科

【摘要】 目的探讨老年股骨近端骨折髋关节置换术后发生对侧骨折的原因,为制定预防措施提供依据。方法选择2015年3月至2019年12月本院行髋关节置换术治疗的147例老年股骨近端骨折患者为研究对象,调查患者的性别、年龄、初次外伤后手术时间、合并基础疾病种数、与照料者关系、功能障碍程度和股骨近端骨小梁类型(Singh)指数分级等情况,统计再骨折发生率并分析其相关原因。结果 147例患者术后发生对侧股骨近端骨折28例,发生率为19.05%。不同合并基础疾病种数、与照料者关系、功能障碍程度、股骨近端Singh指数分级患者,再骨折发生率比较差异均有统计学意义(均P<0.05)。多因素logistic回归分析结果显示,功能障碍程度、合并基础疾病种数、股骨近端Singh指数分级、与照料者关系、年龄分层、初次外伤后手术时间、性别是发生再骨折的独立危险因素(均P<0.05)。结论影响髋关节置换术后发生对侧骨折的原因复杂,应针对高危因素采取相应的预防措施,积极改善患者的躯体功能和认知功能,防治基础疾病和骨质疏松,提高防范跌倒意识。

【Abstract】 Objective To investigate the risk factors of contralateral fractures after hip replacement in elderly patients with proximal femur fractures. Methods One hundred and forty seven elderly patients with proximal femoral fracture treated with hip replacement were enrolled in the study. The contralateral proximal femoral fractures occurred in 28 cases out of 147 patients(19.05%) after operation. The factors related to contralateral fractures were analyzed. Results The incidence of contralateral fractures were significantly associated with the number of comorbid diseases, the relationship with caregivers, degree of dysfunction, proximal femur Singh index in primary fracture side and secondary fracture side(all P<0.05). The multivariate logistic regression analysis showed that the degree of dysfunction, number of comorbid diseases, Singh index of proximal femur,relationship with caregivers, age, the time interval between the first trauma and operation, gender of patients were risk factors of contralateral femur fractures after hip replacement in elderly patients with proximal femur fractures. Conclusion The contralateral fractures after hip replacement are associated with several factors, corresponding preventive measures should be taken according to risk factors to prevent the secondary fractures in elderly patients.

【基金】 浙江省医药卫生科技计划项目(2019KY548)
  • 【文献出处】 浙江医学 ,Zhejiang Medical Journal , 编辑部邮箱 ,2020年18期
  • 【分类号】R687.3
  • 【被引频次】4
  • 【下载频次】29
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