伴有和不伴有肌肉减少症股骨转子间骨折患者内固定后骨折愈合与并发症的比较

Comparison of fracture healing and complications after internal fixation in patients with intertrochanteric fracture with and without concomitant sarcopenia

背景:肌肉减少症与髋部骨折发生密切相关,随着肌肉减少症逐渐被认识并且逐渐深入研究,伴有肌肉减少症的股骨转子间骨折患者也需要被引起足够的重视,以进一步提高老年股骨转子间骨折的疗效,减少并发症。目的:探讨伴有和不伴有肌肉减少症股骨转子间骨折患者内固定后的骨折愈合与并发症发生情况。方法:纳入2014年1月至2020年12月在安徽医科大学附属巢湖医院骨科行股骨近端防旋型髓内钉固定治疗的股骨转子间骨折患者128例,其中61例为非肌肉减少症患者,67例为肌肉减少症患者,统计两组患者术后疼痛情况(目测类比评分)、出血量、骨折愈合时间、住院时间、并发症、Harris髋关节功能恢复情况。结果与结论:128例患者中符合肌肉减少症诊断者67例(52.3%)。与非肌肉减少症组相比,肌肉减少症组患者住院时间更长(P<0.05),并发症发生率更高(P<0.05),髋关节功能恢复优良率更低(P<0.05),术后第1,3天肌肉减少症患者目测类比评分更高(P<0.05)。结果表明,股骨转子间骨折患者肌肉减少症发病率较高,肌肉减少症是股骨转子间骨折患者术后早期预后不佳的危险因素,应当引起足够的重视。

BACKGROUND:Sarcopenia is closely related to the occurrence of hip fractures.As sarcopenia is gradually recognized and studied,enough emphasis should be placed on patients with intertrochanteric fractures combined with sarcopenia,to further improve the curative effect on elderly femoral intertrochanteric fractures and reduce complications.OBJECTIVE:To investigate fracture healing and complications after internal fixation in patients with intertrochanteric fracture concomitant with sarcopenia or not.METHODS:A total of 128 patients with intertrochanteric fractures who underwent anti-rotation intramedullary fixation at the Department of Orthopedics in Chaohu Hospital of Anhui Medical University from January 2014 to December 2020 were selected,of which 61 patients were without sarcopenia,and 67 patients were with sarcopenia.The postoperative pain(visual analogue scale score),blood loss,fracture healing time,hospital stay,complications,and Harris hip score were statistically analyzed in the two groups.RESULTS AND CONCLUSION:Of the 128 patients,67(52.3%)were diagnosed with sarcopenia.Compared with the non-sarcopenia group,patients in the sarcopenia group had longer hospital stays(P<0.05),a higher incidence of complications(P<0.05),and a lower Harris hip score(P<0.05).The visual analogue scale scores of sarcopenia patients were higher than those of non-sarcopenia patients on the 1^(st) and 3^(rd) days after surgery(P<0.05).To conclude,the incidence of sarcopenia is higher in patients with intertrochanteric fractures,and sarcopenia is a risk factor for poor prognosis in patients with intertrochanteric fractures,which should be spotlighted.