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周围假肢和本地偏远大腿骨折之间的临床差异:一项比较观察性研究

Shana Kong¹, Shannon Tse¹, Aziz Saade¹

¹Department of Orthopaedic Surgery, University of California Davis, 4860 Y Street, Suite 3800, Sacramento, CA, 95817, USA.

Journal of orthopaedic surgery and research

|May 20, 2024

概括

老年女性的周围假肢远骨骨折 (PDFF) 是孤立的损伤,与年轻患者的本地远骨骨折 (NDFF) 不同. NDFF患者住院时间较长,再手术率较高,表明有不同的治疗需求.

科学领域:

整形外科手术整形外科手术
创伤外科手术创伤外科
生物医学工程生物医学工程

背景情况:

由于膝关节置换总数的增加,周围假肢远端大腿骨骨折 (PDFF) 的发生率增加.
与本地远骨骨折 (NDFF) 相比,PDFF存在独特的挑战.

研究的目的:

为了比较PDFF和NDFF之间的人口统计,骨折特征,治疗策略和结果.
为了确定这些骨折类型的风险因素和手术管理的差异.

主要方法:

对18岁以上接受NDFF或PDFF手术固定的患者进行了回顾性队列研究 (2012-2020年).
收集的数据包括人口统计,AO/OTA分类,固定,并发伤害,多创伤,骨密度和减少质量.
统计分析包括t测试,费舍尔的精确测试和多变量分析.

主要成果:

70名PDFF (老年女性,隔离,共33个A.3骨折) 和139名NDFF (中年女性,共33个C.2骨折,48%的并发骨折) 被确定.
内钉是两者的主要固定;PDFF显示越来越多的钉板使用.
NDFF的住院时间更长,意外返回OR (UROR) 率更高,减少质量更差 (p<0.05). 在PDFF中,低骨密度的患病率较高 (p<0.05).

结论:

PDFF是老年女性骨质不佳的孤立损伤.
在年轻的患者中,NDFF会发生,同时出现骨折和更高的UROR风险.
虽然内钉是常见的,但固定选择不同,NDFF需要对并发症进行更密切的监测.

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