手术治疗老年髋部骨折术后对侧髋骨再骨折回顾性研究

Retrospectively Study of Surgical Treatment of Elderly Hip Fracture Surgery with Contralateral Hip Fractures

目的:对手术治疗老年髋部骨折术后对侧髋骨再骨折的临床治疗策略与风险因素进行回顾性研究。方法:选取河北港口集团医院骨科2015年2月~2015年12月收治的行手术治疗的648例老年髋部骨折患者,根据患者术后是否继发对侧骨折分为再骨折组与无骨折组,对42例老年髋部骨折手术治疗后继发对侧髋骨再骨折患者的两次骨折手术时间、手术方式、手术前住院时间等进行比较。结果:术后随访显示42例继发对侧髋骨再骨折,发生率为6.5%。两次骨折时患者的SAS分级、入住ICU例数、平均住院时间、手术平均时间、平均总住院时间比较差异均有统计学意义(P<0.05)。结论:老年髋部骨折术后继发对侧髋骨骨折宜在防治基础病及抗骨质疏松的同时进行手术治疗,继发转子间骨折以内固定法进行治疗或假体置换术治疗,而继发股筋骨骨折则首选水泥型股骨头置换术。

Objective：To clinical treatment strategies and risk factors for surgical treatment of elderly hip fracture of lateral hip fracture were retrospectively studied.Methods：In the Hebei Port Group hospital from Feb 2015 to Dec 2015 admitted to the dept.of orthopedics for surgical treatment of 648 Cases of elderly patients with hip fracture,according to whether the contralateral fracture was divided into fracture group and fracture group patients,42 cases of surgical treatment of elderly hip fracture after secondary contralateral hip bone fracture patients with two fracture surgery the operation time and hospitalization time were compared before.Results：648 patients were followed up 42 cases of secondary fracture on the display side of the hip,the incidence rate was 6.5%.The SAS classification,the number of ICU patients,the average length of stay,the average time of operation,the average total length of stay in patients with two fractures were statistically significant（P〈0.05）.Conclusion：Elderly hip fracture secondary contralateral hip fracture of the situation is more complex,clinical treatment should be based on prevention and treatment of disease and osteoporosis and surgical treatment,secondary internal fixation of intertrochanteric fractures.The treatment can also be prosthesis replacement therapy,and after femoral fracture patients and cemented femoral head preferred replacement.