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Analgesic Effect of Combined Spinal-Epidural Anesthesia and its Effect on TNF-α and CRP Levels in Elderly Patients with Hip Fracture During Surgical Treatment
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作者 Jie Xu Linyan Li Ning Wang 《Journal of Clinical and Nursing Research》 2024年第3期7-11,共5页
Objective:To observe the analgesic effect of combined spinal and epidural anesthesia on older patients undergoing hip fracture surgery.Method:One hundred and twenty elderly hip fracture surgery patients treated in our... Objective:To observe the analgesic effect of combined spinal and epidural anesthesia on older patients undergoing hip fracture surgery.Method:One hundred and twenty elderly hip fracture surgery patients treated in our hospital from January 2021 to December 2022 were selected and randomly divided into two groups,with 60 cases in the experimental group and 60 in the control group.The experimental group was given combined spinal-epidural anesthesia intervention measures,while the control group was given epidural anesthesia intervention measures.The analgesic effect,tumor necrosis factor-alpha(TNF-α),C-reactive protein(CRP)levels,and other observation indicators were analyzed after anesthesia intervention.Result:After the intervention,the analgesic effect and the evaluation results of the subjects in the experimental group were better than those in the control group(P<0.05);the obtained values of TNF-αand CRP levels in the experimental group were higher than those of the control group(P<0.05).Conclusion:The combined spinal-epidural anesthesia intervention demonstrated positive outcomes.The analgesic effect of patients during surgery and their inflammatory factor levels improved,which makes this intervention worthy of clinical application and promotion. 展开更多
关键词 hip fracture in the elderly SURGERY Combined spinal and epidural anesthesia Analgesic effect TNF-Α CRP level
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Total hip arthroplastyvs. osteosynthesis in acute complex acetabular fractures in the elderly:Evaluation of surgical management and outcomes 被引量:3
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作者 Serafino Carta Gabriele Falzarano +7 位作者 Giuseppe Rollo Predrag Grubor Mattia Fortina Luigi Meccariello Antonio Medici Alberto Riva Luca Sampieri Paolo Ferrata 《Journal of Acute Disease》 2017年第1期12-17,共6页
Objective: To retrospectively evaluate the open reduction internal fixation and total hip arthroplasty directions, results and complications associated with internal fixation in managing these fractures. <br> Me... Objective: To retrospectively evaluate the open reduction internal fixation and total hip arthroplasty directions, results and complications associated with internal fixation in managing these fractures. <br> Methods: In 8 years at 4 centers, 61 patients with associated acetabular fractures (Letournel classification) were treated. The patients were divided into two groups. The total hip arthoplasty (THA) group consisted of 30 patients, while the open reduction internal fixation group had 31 patients. The average age of the patients was 74.7 years. The following parameters were compared: the duration of surgery and hospitalization, the international unit of red blood cell concentrate transfusion, the time for the verticalization of the patient, perioperative complications, Harris hip score, and the short form (12) health survey. The clinical and radiographic follow-up was performed at 1 month, 3 months, 6 months and 12 months and annually thereafter. Patients with post-traumatic osteoarthritis formed the third comparison group.P≤ 0.05 was considered statistically significant according to the analytical Student’s t-test. <br> Results: TheP < 0.05 in favor of theTHAgroup was: surgical time, length of stay, number of the international unit of red blood cell concentrate transfusions, verticalization, quality of life and hip function, a reduction of perioperative complications and reinterventions. <br> Conclusions: Our experience shows that theTHA treatment for acetabular fractures in the elderly is to be preferred. 展开更多
关键词 ACETABULUM fracture elderly OSTEOPOROSIS Total hip ARTHROPLASTY OSTEOSYNtheSIS
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Preventing Lower Extremity Deep Vein Thrombosis After Hip Fracture Surgery in Elderly Patients by Acupoint Application Combined with Pneumatic Compression Therapy 被引量:2
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作者 Xing Fu Yan Cheng 《Proceedings of Anticancer Research》 2022年第2期6-9,共4页
Objective:To investigate and analyze the long-term clinical effects of acupoint application combined with pneumatic compression therapy in the prevention of deep venous thrombosis after hip fracture surgery among the ... Objective:To investigate and analyze the long-term clinical effects of acupoint application combined with pneumatic compression therapy in the prevention of deep venous thrombosis after hip fracture surgery among the elderly.Methods:Sixty elderly patients who had undergone hip fracture surgery from February 2021 to February 2022 were selected as the research subjects.The patients were divided into two groups via drawing lots.Both the groups received nursing care,but the patients in the observation group were treated with TCM acupoint application combined with pneumatic compression therapy,whereas the control group received pneumatic compression therapy.The evaluation indicators included the patients’quality of life and complications.Results:The incidence of lower extremity deep vein thrombosis in the observation group was more than twice(0.3%),whereas the incidence of lower extremity complications in the control group was more than 6 times(20%).There was a significant difference between the two groups(p<0.05).Conclusion:Traditional Chinese medicine acupoint application combined with pneumatic compression therapy is beneficial for the prevention of postoperative lower extremity deep vein thrombosis among elderly patients.In addition,the patients’overall quality-of-life scores in both physiological and psychological aspects improved significantly,which carries significant clinical reference value. 展开更多
关键词 Acupoint application Traditional Chinese medicine Pneumatic compression therapy Minimally invasive surgery for hip fracture in elderly patients Lower extremity deep vein thrombosis
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Trochanteric Fracture of a Congenital/Developmental Dislocation of the Hip in an Elderly Woman: A Case Report
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作者 Kazuhiro Imai 《Open Journal of Orthopedics》 2011年第1期1-4,共4页
An 87-year-old woman with a residual dislocated hip suffered a trochanteric fracture on the ipsilateral side. The fracture was treated by open reduction and internal fixation surgery with good results. To treat a prox... An 87-year-old woman with a residual dislocated hip suffered a trochanteric fracture on the ipsilateral side. The fracture was treated by open reduction and internal fixation surgery with good results. To treat a proximal femoral fracture of the residual dislocated hip in an elderly patient, the patient’s overall status, pre-fracture ability, hip joint configuration, and fracture pattern should be considered. 展开更多
关键词 Congenital/Developmental DISLOCATION of the hip Trochanteric fracture elderly WOMAN
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Observation on the Risk of Falling and Self-efficacy in Elderly Patients with Hip Fracture
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作者 Zongyou Mou Ke Song Jinquan Guo 《Journal of Clinical and Nursing Research》 2019年第4期5-8,共4页
Objectives:To study the risk of falling and self-efficacy in elderly patients with hip fracture.Methodology:Forty elderly patients with hip fractures that were caused by falling were admitted into our hospital from Ap... Objectives:To study the risk of falling and self-efficacy in elderly patients with hip fracture.Methodology:Forty elderly patients with hip fractures that were caused by falling were admitted into our hospital from April 2018 to April 2019,and were enrolled into this study.All patients were assessed by using the Morse Fall Scale(MFS)and Falls Efficacy Scale(FES).The basic situation of the patients with hip fractures caused by falling and the scores of MFS and FES before and after falling were evaluated.Results:Results showed that the number of patients with femoral neck fractures accounted for 70%out of all patients,and the number of patients with intertrochanteric fractures accounted for the remaining 30%of the patients.The number of patients with academic qualification below primary school is 16,the number of patients with middle high school education is 11 and the number of patients with high school education and above is 13.Slipping is the cause of hip fracture that accounted for the most in patients,followed by outing activities,whereas least patients with hip fractures was caused by falling in nursing home.There were 29 patients’who used crutches or walking aids and this number was more than that of those who required the devices.After the MFS and FES analyses,the results(scores of MFS and FES)showed that the risk before the fall was lower.In contrast,the risk of fracture and post-surgery after the fall was greatly increased.Conclusion:The elderly patients with hip fractures were found to have increased risk of falling and thus,these patients require good care. 展开更多
关键词 elderly hip fracture RISK of FALLinG SELFEFFICACY
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Control study of short-term curative effect of minimally invasive total hip arthroplasty using metal-on-metal large-diameter femoral head for the elderly patients with femoral neck fractures
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作者 何锐 《外科研究与新技术》 2011年第2期116-117,共2页
Objective To discuss the postoperative curative effects of two surgical techniques of minimally invasive total hip arthroplasty (THA) using metal-on-metal largediameter and conventional diameter femoral head for the e... Objective To discuss the postoperative curative effects of two surgical techniques of minimally invasive total hip arthroplasty (THA) using metal-on-metal largediameter and conventional diameter femoral head for the elderly patients 展开更多
关键词 THA head Control study of short-term curative effect of minimally invasive total hip arthroplasty using metal-on-metal large-diameter femoral head for the elderly patients with femoral neck fractures
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The impact of operative timing on clinical outcomes in elderly hip fracture
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作者 王晓伟 《外科研究与新技术》 2011年第2期117-118,共2页
Objective To study the effect of operative timing on clinical outcomes in elderly hip fracture.Methods Two hundred sixty-seven patients with hip fracture were treated from July 2006 to May 2008.The patients who had an... Objective To study the effect of operative timing on clinical outcomes in elderly hip fracture.Methods Two hundred sixty-seven patients with hip fracture were treated from July 2006 to May 2008.The patients who had an operation within 展开更多
关键词 the impact of operative timing on clinical outcomes in elderly hip fracture
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Effects of surgical treatment modalities on postoperative cognitive function and delirium in elderly patients with extremely unstable hip fractures
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作者 Xue Zhou Xiao-Hua Chen +3 位作者 Sheng-Hua Li Nan Li Feng Liu Hao-Ming Wang 《World Journal of Psychiatry》 SCIE 2023年第8期533-542,共10页
BACKGROUND As the perioperative risk of elderly patients with extremely unstable hip fractures(EUHFs)is relatively high and therapeutic effect is not satisfactory,new therapeutic strategies need to be proposed urgentl... BACKGROUND As the perioperative risk of elderly patients with extremely unstable hip fractures(EUHFs)is relatively high and therapeutic effect is not satisfactory,new therapeutic strategies need to be proposed urgently to improve the efficacy and clinical outcomes of such patients.AIM To determine the influence of two surgical treatment modalities on postoperative cognitive function(CF)and delirium in elderly patients with EUHFs.METHODS A total of 60 elderly patients consecutively diagnosed with EUHF between September 2020 and January 2022 in the Chongqing University Three Gorges Hospital were included.Of them,30 patients received conventional treatment(control group;general consultation+fracture type-guided internal fixation),and the other 30 received novel treatment(research group;perioperative multidisciplinary treatment diagnosis and treatment+individualized surgical plan+risk prediction).Information on hip function[Harris hip score(HHS)],perioperative risk of orthopedic surgery[Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity(POSSUM)],CF[Montreal cognitive assessment scale(MoCA)],postoperative delirium[mini-cognitive(Mini-Cog)],adverse events(AEs;internal fixation failure,infection,nonunion,malunion,and postoperative delirium),and clinical indicators[operation time(OT),postoperative hospital length of stay(HLOS),ambulation time,and intraoperative blood loss(IBL)]were collected from both groups for comparative analyses.RESULTS The HHS scores were similar between both groups.The POSSUM score at 6 mo after surgery was significantly lower in the research group compared with the control group,and MoCA and Mini-Cog scores were statistically higher.In addition,the overall postoperative complication rate was significantly lower in the research than in the control group,including reduced OT,postoperative HLOS,ambulation time,and IBL.CONCLUSION The new treatment modality has more clinical advantages over the conventional treatment,such as less IBL,faster functional recovery,more effectively optimized perioperative quality control,improved postoperative CF,mitigated postoperative delirium,and reduced operation-related AEs. 展开更多
关键词 Extremely unstable hip fracture elderly Multidisciplinary treatment Cognitive function Postoperative delirium
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Clinical analysis of nosocomial infection in 180 elderly patients with hip fractures
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作者 荣凤菊 《外科研究与新技术》 2011年第4期264-264,共1页
Objective To discuss the hip fracture in elderly patients with nosocomial infection,to take effective prevention and control measures. Methods Retrospective analysis of data of the elderly hip fracture combined with n... Objective To discuss the hip fracture in elderly patients with nosocomial infection,to take effective prevention and control measures. Methods Retrospective analysis of data of the elderly hip fracture combined with nosocomial infection during 2009 - 2010 was performed. Results A total of 180 cases of femoral neck 展开更多
关键词 Clinical analysis of nosocomial infection in 180 elderly patients with hip fractures
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Optimization of transdisciplinary management of elderly with femur proximal extremity fracture:A patient-tailored plan from orthopaedics to rehabilitation 被引量:4
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作者 Alessandro de Sire Marco Invernizzi +4 位作者 Alessio Baricich Lorenzo Lippi Antonio Ammendolia Federico Alberto Grassi Massimiliano Leigheb 《World Journal of Orthopedics》 2021年第7期456-466,共11页
Fractures of femur proximal extremity(FFPE)are the most common fragility fractures requiring hospitalization,with a high risk of mortality,low independence in the activities of daily living and severe consequences on ... Fractures of femur proximal extremity(FFPE)are the most common fragility fractures requiring hospitalization,with a high risk of mortality,low independence in the activities of daily living and severe consequences on healthrelated quality of life.Timing for surgery has a key role in the management of elderly patients with FFPE as recommended by the Australian and New Zealand guidelines and the National Institute for Health and Care Excellence guidelines.Early surgery(within 48 h from hospital admission)allows significant benefits in terms of lower rates of postoperative complications and risk of death and can provide better functional outcomes.Therefore,time for surgery could be considered as a comorbidity marker.The choice between conservative or surgical approach surprisingly seems to be still not strongly supported by available literature,but it seems that both 30 d and 1 year risk of mortality is higher with the conservative treatment rather than with surgery.In light of these considerations,the optimization of FFPE management care is mandatory to improve functional outcomes and to reduce sanitary costs.Albeit it is widely accepted that transdisciplinary approach to patients suffering from FFPE is mandatory to optimize both short-term and long-term outcomes,the feasibility of a comprehensive approach in clinical practice is still a challenge.In particular,the large variability of figures involved could be considered both a resource and an additional disadvantage taking into account the difficulty to coordinate multidisciplinary approach covering care in all settings.Therefore,the aim of the present article was to summarize current evidence supporting transdisciplinary management of patients with FFPE,highlighting the benefits,feasibility and limitations of this approach. 展开更多
关键词 Transdisciplinary management elderly Femur fracture hip fracture REHABILITATION Pathway
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Early Surgery in Femoral Neck Fractures in Elderly: Does Preoperative ASA Score Matter?
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作者 Stefania De Sanctis Raffaella Alonzo +5 位作者 Silvia Frontini Ilaria Nicolosi Fabio Belvederi Edoardo Monaco Attilio Speranza Carmelo D’Arrigo 《International Journal of Clinical Medicine》 2016年第12期829-836,共9页
Introduction: Early surgical treatment (within 48 hours) has been recommended for femoral neck fractures in order to avoid complications and reduce mortality rate, regardless of presence and severity of comorbidity an... Introduction: Early surgical treatment (within 48 hours) has been recommended for femoral neck fractures in order to avoid complications and reduce mortality rate, regardless of presence and severity of comorbidity and preoperative status (ASA score). However some studies evidenced that early surgery doesn’t always have a beneficial effect on mortality and complications. Therefore further studies could be useful in order to better assess risk related factors of patients requiring surgical treatment for femoral neck fracture. The purpose of this study is to evaluate the effect of preoperative ASA score and timing of surgery on mortality, complications and clinical outcome. Methods: All 336 patients operated in our center from January 2013 to December 2014 were selected for this retrospective study. Patients were divided in three groups as follows: group 1 patients treated within 48 hours;group 2 patients treated between 48 to 96 hours;group 3 patients treated over 96 hours. The preoperative ASA score was recorded for each patient. Complication, clinical outcome and mortality at one-year follow-up were evaluated. At follow-up ambulation was graded as: confined to bed, assisted ambulation, and normal ambulation. Complications both local (infections, malunion, dislocation) and systemic (deep vein thrombosis, pulmonary embolism, lung infections, ischemic disorders of heart) were recorded as well as number of transfusions. Statistical analysis was performed with chi square test and P value Results: 308 patients’ data were fully available for this study. At one-year follow-up return to normal ambulation was higher for patients of group 1 as compared with group 2 and 3 and in group 2 as compared with group 3 (P = 0.04). There was no difference in mortality and return to ambulation between patients with ASA score 1 and 2 (P = 0.06);patients with ASA score ≥ 3 showed a statistically significant higher mortality (P = 0.004) and rate of complications (0.0008) regardless of timing of surgery. There was no statistically significance in blood transfusion among the three groups. Discussion and Conclusion: Clinical outcome, complications and mortality have been previously reported from many authors and most studies agreed that early surgical treatment is recommended regardless of age and preoperative status of the patient. The present study suggests that early surgical treatment is actually able to reduce mortality and complications and to improve clinical outcome in patients with better preoperative conditions, while for patients with ASA score ≥ 3 treatment within 48 hours seems not to prevent mortality and complications and improve clinical outcome. 展开更多
关键词 Femur fractures ASA Score Early Surgery elderly hip Surgery
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Effect of early surgery in high surgical risk geriatric patients with femoral neck fracture and taking antiplatelet agents 被引量:6
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作者 Paphon Sa-ngasoongsong Noratep Kulachote +7 位作者 Norachart Sirisreetreerux Pongsthorn Chanplakorn Sukij Laohajaroensombat Nithiwut Pinsiranon Patarawan Woratanarat Viroj Kawinwonggowit Chanyut Suphachatwong Wiwat Wajanavisit 《World Journal of Orthopedics》 2015年第11期970-976,共7页
AIM: To investigate the effect of early surgical intervention on the high surgical risk elderly patients who sustained femoral neck fracture(FNF) and taking concomitant antiplatelet agents. METHODS: Between 2010 and 2... AIM: To investigate the effect of early surgical intervention on the high surgical risk elderly patients who sustained femoral neck fracture(FNF) and taking concomitant antiplatelet agents. METHODS: Between 2010 and 2012, a prospective study was conducted on 49 geriatric patients, who took antiplatelet agents, sustained FNF and underwent surgery within 72 h [early surgery(ES) group], and these were compared with a retrospective consecutive case series of patients with similar characteristics(45 cases) who had delayed surgery(DS group) after 72 h during an earlier 3-year period. Postoperative outcomeswere followed for one year and compared. RESULTS: There were non-significant differences in perioperative blood loss, blood transfusion, intensive care unit requirement and postoperative mortality(P > 0.05 all). There were 2 patients(4%) in the DS group who died after surgery(P = 0.23). However, the ES group showed a significantly better postoperative outcome in terms of postoperative complications, length of hospital stay, and functional outcome(P < 0.05 all).CONCLUSION: Early hip surgery in geriatric hip fracture patients with ongoing antiplatelet treatment was not associated with a significant increase of perioperative blood loss and postoperative mortality. Moreover, ES resulted in a better postoperative surgical outcome. In early hip surgery protocol, the antiplatelet agents are discontinued and the patient is operated on within 72 h after admission, which is safe and effective for the medically fit patients. 展开更多
关键词 Early hip surgery Blood loss elderly hip fracture ANTIPLATELET agents DISPLACED FEMORAL neck fracture hip ARTHROPLASTY
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Prognostic factors and predictive model for in-hospital mortality following hip fractures in the elderly 被引量:12
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作者 J. Sanz-Reig J. Salvador Marin +3 位作者 J. Ferrandez Martinez D. Orozco Beltran J.F. Martinez Lopez J.A. Quesada Rico 《Chinese Journal of Traumatology》 CAS CSCD 2018年第3期163-169,共7页
Purpose: The incidence of hip fractures is increasing within the aging population. Our objective was to identify and quantify the risk factors and develop a predictive model for the in-hospital mortality among hip fr... Purpose: The incidence of hip fractures is increasing within the aging population. Our objective was to identify and quantify the risk factors and develop a predictive model for the in-hospital mortality among hip fracture patients older than 65 years. Methods: This is a prospective study conducted on 331 hip fracture patients older than 65 years admitted to our hospital from 2011 to 2014. Patients' demographics, prehospitalization residential status, pre- fracture comorbidity data, anti-aggregant and anticoagulant medication, preoperative hemoglobin value, type of fractures, type of treatments, time to surgery, and complications were recorded. Results: The average age was 83 years, 73% female, and 57% of them sustained a femoral neck fracture. In 62.8% of patients, the number of pre-fracture baseline comorbidities was 〉2. The in-hospital mortality rate was 11.4%. In multivariate analysis, age over 90 years, congestive heart failure, asthma, rheumatologic disease, lung cancer, and not taking antiaggregant medication were independently associated with in-hospital mortality. A formula and risk stratification scoring for predicting the risk for in-hospital mortality was developed, Risk-adjustment model based on these variables had acceptable accuracy for predicting in-hospital mortality (c-statistic 0.77). Conclusion: Advanced age, and five prefracture comorbidities have a strong association with in-hospital mortality in a hip fracture patient older than 65 years old. Our predictive model was specifically designed for the old hip fracture population. It has an accuracy similar to other risk models. The specificity, positive predictive value, and negative predictive value are high. In addition, it could discriminate a high risk patient from a low risk patient for in-hospital mortality. 展开更多
关键词 hip fractures in-hospital mortality Prognostic factors Elder population
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Factors influencing postoperative mortality one year after surgery for hip fracture in Chinese elderly population 被引量:22
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作者 LI Shao-guang SUN Tian-sheng LIU Zhi REN Ji-xin LIU Bo GAO Yang 《Chinese Medical Journal》 SCIE CAS CSCD 2013年第14期2715-2719,共5页
Background Disability and death following hip fracture is becoming more common as the population ages. Previous reports have focused on the selection of internal fixation methods and the analysis of the perioperative ... Background Disability and death following hip fracture is becoming more common as the population ages. Previous reports have focused on the selection of internal fixation methods and the analysis of the perioperative therapeutic results in the Chinese population. Few studies have focused on factors influencing medium and long term survival after surgery for hip fracture. We conducted a retrospective study on the factors influencing survival one year after hip fracture surgery in our elderly Chinese population to provide a reference for improved treatment and to enhance efficacy. Methods Records from patients undergoing treatment for hip fracture at our hospital from October 2009 through June 2011 were retrospectively reviewed. Through telephone follow-up, the health condition of each patient was surveyed, and the 1-year postoperative mortality was analyzed. The patients' age, gender, fracture type, pre-injury health condition, mobility, complications, surgical timing, surgical types, methods of anesthesia, and postoperative complications were analyzed. Univariate and multivariate regression analysis was performed on relevant influencing factors. Results A total of 184 patients had complete data and were followed-up for 12-23 months (average, 16.5 months). There were 30 deaths (16.3%) at one-year. Univariate analysis revealed that factors such as age, gender, fracture-type, number of co-existing diseases, complications such as chronic obstructive pulmonary disease or sequelae of stroke, American society of Anesthesiology (ASA) scores, anesthesia methods, pre-injury activity, and post-operative complications were significantly different between survival versus mortality groups (P 〈0.05). Multivariate regression analysis revealed that age, ASA score, pre-injury mobility and combined chronic obstructive pulmonary disease were independent risk factors for death. Conclusion Full consideration of medium-/long-term risk factors in the treatment of hip fracture in the elderly, selection of appropriate anesthesia and treatment methods, and improved pre-surgical health conditions would reduce postoperative mortality and enhance surgical efficacy. 展开更多
关键词 elderly hip fracture MORTALITY risk factors
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Comparison of Proximal Femoral Geometry and Risk Factors between Femoral Neck Fractures and Femoral Intertrochanteric Fractures in an Elderly Chinese Population 被引量:33
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作者 Zu-Sheng Hu Xian-Ling Liu Ying-Ze Zhang 《Chinese Medical Journal》 SCIE CAS CSCD 2018年第21期2524-2530,共7页
Background: Few studies have investigated the differences in proximal femoral geometry and risk factors between patients with different types of hip fracture, especially in elderly Chinese. This study aimed to assess... Background: Few studies have investigated the differences in proximal femoral geometry and risk factors between patients with different types of hip fracture, especially in elderly Chinese. This study aimed to assess the differences in proximal femoral geometry parameters between patients with femoral neck fractures and patients with intertrochanteric fractures to provide guidance for individualized customized prosthesis and accurate reconstruction of proximal femurs in elderly Chinese patients. Methods: We retrospectively studied the electronic medical records of 198 elderly patients over 65 years of age who were admitted to the orthopedic department with hip fractures between January 2017 and December 2017 in The Third Hospital, Hebei Medical University. Age, fracture site, gender, and proximal femoral geometry parameters (.neck shaft angle [NSA], center edge angle [CEA], femoral head diameter [FHD], femoral neck diameter [FND], femoral neck axial length [FNAL], hip axial length [HAL], and femoral shaft diameter [FSD]) were recorded. Student's t-test was used to compare the continuous variables, Chi-square test was used to analyze categorical variables, and multiple logistic stepwise regression analysis was used to evaluate the influencing factors of hip fracture type. Results: Statistically significant differences in NSA (137.63 ± 4.56° vs. 132.07 ± 4.17°, t = 1.598, P 〈 0.001), CEA (37.62 ± 6.77° vs. 43.11 ±7.09°, t = 5.597, P 〈 0.001 ), FND (35.21 ± 3.25 mm vs. 34.09 ±3.82 mm, t = 2.233, P = 0.027), and FNAL (99.30 ± 7.91 mm vs. 103.58± 8.39 ram, t = 3.715, P 〈 0.001 ) were found between the femoral neck fracture group and femoral intertrochanteric fracture group. FHD, FND, FSD, HAL, and FNAL were different between sexes (all P 〈 0.001 ). The greater NSA was the risk factor for femoral neck fractures (,odds ratio [OR]: 0.70, P 〈 0.001 ), greater CEA and longer FNAL were risk factors for femoral intertrochanteric fractures (OR: 1.15, 1.17, all P 〈 0.001), and greater FND was a protective factor for femoral intertrochanteric fractures (OR: 0.74, P 〈 0.001). Conclusions: We demonstrate differences in geometric morphological parameters of the proximal femur in different hip fracture types, as well as an effect of sex. These differences should he considered in the selection of prostheses for fracture internal fixation and hip replacements. These data could help guide the design of individualized customized prostheses and improve the accurate reconstruction of the proximal femur for elderly Chinese hip fracture patients. 展开更多
关键词 Chinese Population elderly Femoral Neck fractures hip Geometry intertrochanteric fractures of the Femur Risk Factor
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全髋关节置换术中关节囊修复对创伤性股骨颈骨折患者预后的影响
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作者 刘敏 张景业 +1 位作者 陈恩玉 李栋梁 《中国医学创新》 CAS 2024年第29期5-9,共5页
目的:探讨全髋关节置换术中关节囊修复对创伤性股骨颈骨折患者预后的影响。方法:选择2018年1月—2022年12月九江学院附属医院收治的102例创伤性股骨颈骨折患者。根据随机数字表法分为两组,各51例。对照组行全髋关节置换术中不对关节囊修... 目的:探讨全髋关节置换术中关节囊修复对创伤性股骨颈骨折患者预后的影响。方法:选择2018年1月—2022年12月九江学院附属医院收治的102例创伤性股骨颈骨折患者。根据随机数字表法分为两组,各51例。对照组行全髋关节置换术中不对关节囊修复,研究组应用全髋关节置换术中关节囊修复。比较两组手术相关指标、手术应激指标、髋关节功能、疼痛情况及并发症发生情况。结果:两组切口长度、术中出血量比较,差异均无统计学意义(P>0.05);研究组手术时间长于对照组,术后引流量少于对照组,差异均有统计学意义(P<0.05)。术后1 d,两组皮质醇(Cor)、去甲肾上腺素(NE)均高于术前,差异均有统计学意义(P<0.05),但两组间比较,差异均无统计学意义(P>0.05)。术前及术后6、12个月,两组Harris髋关节功能评分比较,差异均无统计学意义(P>0.05),术后1、3个月,研究组Harris髋关节功能评分均高于对照组,差异均有统计学意义(P<0.05)。术后3个月,研究组视觉模拟评分法(VAS)评分低于对照组,差异有统计学意义(P<0.05);术后6、12个月,两组VAS评分比较,差异均无统计学意义(P>0.05)。研究组并发症发生率为1.96%,低于对照组的15.69%,差异有统计学意义(P<0.05)。结论:全髋关节置换术中关节囊修复虽然会延长手术时间,但可促进创伤性股骨颈骨折患者近期预后,降低并发症发生情况。 展开更多
关键词 创伤性股骨颈骨折 并发症 关节囊修复 全髋关节置换术
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Optimized clinical practice for superaged patients with hip fracture:significance of damage control and enhanced recovery program 被引量:9
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作者 Zaiyang Liu Jun Zhang +2 位作者 Kaiqi He Yumei Zhang Yuan Zhang 《Burns & Trauma》 SCIE 2019年第1期194-203,共10页
With the advent of global aging,the incidence,mortality,and medical costs of hip fracture among aged patients are increasing annually.The number of controlled clinical studies and health economics analyses that confor... With the advent of global aging,the incidence,mortality,and medical costs of hip fracture among aged patients are increasing annually.The number of controlled clinical studies and health economics analyses that conform to evidence-based medicine principles is growing day by day.However,unfortunately,no specific recommendations regarding the procedures for the treatment of hip fracture are available.Meanwhile,the existence of both traditional treatment systems and new treatment theories means that most doctors confront difficult choices in their daily practice.These factors make the therapeutic approach for aged patients,especially among superaged patients with hip fracture,extremely challenging.This study focuses on superaged patients(>80 years as defined by the World Health Organization)with hip fracture and includes their preoperative pathological condition;therapeutic decision-making in terms of the benefit and risk ratio,damage control theory,and enhanced recovery after surgery were also investigated.These patients were discussed specifically by combining the current treatment strategies from several experts and the results of a meta-analysis published recently.The study presents some new ideas and approaches currently recognized in the field,such as preoperative assessment,surgical planning,safety consideration,complication intervention,and enhanced recovery implementation,and further presents some clear interpretations regarding misunderstandings in clinical practice.Finally,optimized treatment according to damage control principles and enhanced recovery after surgery during the perioperative period among superaged hip fracture patients is defined. 展开更多
关键词 hip fracture Superaged patient Femoral neck fracture Femoral intertrochanteric fracture Damage control elderly orthopedic care
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Acetabulum fractures in elderly patients:A review 被引量:2
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作者 Ashwani Soni Ravi Gupta Ramesh Sen 《Chinese Journal of Traumatology》 CAS CSCD 2022年第6期331-335,共5页
Fractures of the acetabulum in elderly patients were often caused by low energy trauma.Fractures involving anterior column are more common and often associated with impaction and comminution.Osteoporosis further compl... Fractures of the acetabulum in elderly patients were often caused by low energy trauma.Fractures involving anterior column are more common and often associated with impaction and comminution.Osteoporosis further complicates the management.Percutaneous fracture fixation has low morbidity but it is a technically demanding procedure.Open reduction and fracture fixation is done with or without simultaneous total hip replacement.Delayed total hip replacement is considered in posttraumatic arthritis patients.Patients with minimal displaced fractures,associated both-column fractures with secondary congruence of joint and patients who are medically unfit for surgery can be managed non-operatively.Whatever be the method of management,these elderly patients should be mobilised as early as possible. 展开更多
关键词 ACETABULUM elderly fracture OSTEOPOROSIS hip ARTHROPLASTY
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营养状况、骨代谢及股骨颈强度指数和骨髓脂质分数与老年髋部骨折术后关节功能恢复的关系研究 被引量:1
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作者 胡勇 《临床研究》 2024年第1期37-40,共4页
目的探究营养状况、骨代谢及股骨颈强度指数(FSI)和骨髓脂质分数(LF)与老年髋部骨折术后关节功能恢复的关系。方法选取2021年6月至2023年6月于原阳县中心医院接受治疗的髋部骨折手术老年患者160例为研究对象。根据患者髋关节功能恢复情... 目的探究营养状况、骨代谢及股骨颈强度指数(FSI)和骨髓脂质分数(LF)与老年髋部骨折术后关节功能恢复的关系。方法选取2021年6月至2023年6月于原阳县中心医院接受治疗的髋部骨折手术老年患者160例为研究对象。根据患者髋关节功能恢复情况进行分组,恢复良好患者87例纳入良好组,恢复不良患者73例纳入不良组。对比两组患者一般资料、营养状况、骨代谢及FSI和LF。结果良好组年龄≥75岁比例、体重、体质量指数(BMI)、股骨粗隆间骨折比例、Ⅰ型胶原蛋白N端肽(NTX)、抗酒石酸酸性磷酸酶5b(TPACP-5b)水平表达均低于不良组,差异均有统计学意义(P<0.05);良好组微型营养评定(MNA)评分、FSI、LF、骨钙蛋白(BGP)水平表达均高于不良组,差异均有统计学意义(P<0.05);经Logistic回归分析,MNA评分、LF、FSI、NTX、TPACP-5b、BGP水平表达均为影响老年髋部骨折术后关节功能恢复情况的独立危险因素,差异有统计学意义(P<0.05);经受试者工作特征(ROC)曲线分析,MNA评分、FSI、LF、NTX、TPACP-5b水平表达均对老年髋部骨折术后关节功能恢复情况有较高的预测价值,曲线下面积(AUC)值分别为0.936、0.874、0.866、0.884、0.825;BGP水平表达的AUC值为0.634,可作为次要参考。结论观察行髋部骨折手术的老年患者术后营养状况、骨代谢及股骨颈强度指数和骨髓脂质分数的变化情况,有利于早期预测患者术后髋关节功能恢复情况,从而制定相应防控措施,帮助患者早日康复。 展开更多
关键词 髋部骨折 老年患者 关节功能 营养状况 骨代谢 股骨颈强度指数 骨髓脂质分数
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股骨颈骨折患者全髋关节置换术中行关节囊修复的效果观察
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作者 李鹏乐 邵誉亮 +1 位作者 杨小广 王斌 《智慧健康》 2024年第10期65-68,共4页
目的探讨股骨颈骨折患者全髋关节置换术中行关节囊修复的效果。方法选取2016年7月—2023年7月本院收治的30例股骨颈骨折患者为研究对象,根据治疗方式的差异将研究对象均分为两组,所有患者都实施全髋关节置换术,观察组术中行关节囊修复,... 目的探讨股骨颈骨折患者全髋关节置换术中行关节囊修复的效果。方法选取2016年7月—2023年7月本院收治的30例股骨颈骨折患者为研究对象,根据治疗方式的差异将研究对象均分为两组,所有患者都实施全髋关节置换术,观察组术中行关节囊修复,对照组术中未行关节囊修复。对比两组患者的临床效果。结果相比于对照组,观察组的显性与隐性失血量都要更少,组间差异有统计学意义(P<0.05);与治疗前相比,两组患者的髋关节功能评分(Harris)、Berg平衡量表评分(BBS)都有不同程度的提高,与对照组相比,观察组的改善幅度更高,组间差异有统计学意义(P<0.05);观察组患者的首次下床活动时间较对照组要提前,住院时间短于对照组,组间差异有统计学意义(P<0.05);同时观察组患者的生活质量评分要比对照组高,组间差异有统计学意义(P<0.05)。结论关节囊修复在股骨颈骨折患者全髋关节置换术中作用显著,能够有效减少患者在围手术期的显性失血量与隐性失血量,能够缩短患者的首次下床时间与住院时间,并且在手术后,患者的髋关节功能与平衡功能均恢复更好,生活质量得到提升。 展开更多
关键词 股骨颈骨折 全髋关节置换术 关节囊修复
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