骨质疏松对老年患者转子间骨折愈后的影响

Effect of anti-osteoporosis treatment on healing of intertrochanteric fractures in elderly patients

目的 通过对老年患者转子间骨折术后的相关资料进行分析,探讨髋部骨折术后早期应用抗骨质疏松治疗对患者预后的影响.方法 采用回顾性研究方法,以我院骨科收治的2011年3月至2013年3月术前因低能量损失致转子间骨折的95例患者进行回顾性研究并随访,分析骨折愈合时间,内固定失败率,髋部Harris功能评分,髋部再骨折情况及病死率.结果 所有患者均顺利完成手术,并早期活动下肢.抗骨质疏松治疗组骨折愈合时间为2.0~3.0个月,平均2.6个月;非抗骨质疏松组为3.0~7.0个月,平均4.1个月.内固定失败率：抗骨质疏松组（5.2%）与非抗骨质疏松组（11.1%）相比更低.末次随访Harris评分：抗骨质疏松组（平均89.5分）相比非抗骨质疏松组（平均83.0分）更高.髋部再骨折均未发生.抗骨质疏松组病死率（6.5%）较非抗骨质疏松组（11.1%）低.结论 转子间骨折术后早期应用抗骨质疏松治疗患者骨折愈合时间短,内固定失败率低,病死率低,疗效满意.

Objective To investigate the early use of anti-osteoporosis treatment after operation of elderly patients with intertrochanteric fractures to find the effect of this treatment on healing of the hip fractures. Methods A total of 95 patients with low energy-induced intertrochanteric fractures from March 2011 to March 2013 in our hospital were retrospectively studied. The fracture healing time, fixation failure rate, Harris score, hip re-fracture and mortality were analyzed. Results All cases have been successfully operated, and achieved early activity of lower limb. Fracture healing time in anti-osteoporosis treatment group and non-anti-osteoporosis group was 2. 6 months （2-3 months） and 4. 1 months （3 7 month）. The internal fixation failure rate in anti-osteoporosis group （5.2%） was lower than in non-anti-osteoporosis group （11. 1%）. The mean Harris score in anti-osteoporosis treatment group （89.5） was higher than in non-anti-osteoporosis group （83.0）. There was no hip refracture. The mortality in anti osteoporosis group （6. 5%） was lower than in non-anti-osteoporosis group （11. 1%）. Conclusion Early use of anti osteoporosis treatment after operation of intertrochanteric fractures in elderly patients makes better effectiveness.