中华创伤骨科杂志
中華創傷骨科雜誌
중화창상골과잡지
CHINESE JOURNAL OF ORTHOPAEDIC TRAUMA
2013年
2期
97-101
,共5页
周耀东%陈宇杰%袁慧仪%罗强%梁加利
週耀東%陳宇傑%袁慧儀%囉彊%樑加利
주요동%진우걸%원혜의%라강%량가리
股骨骨折%二磷酸盐类%骨折固定术,髓内%非典型骨折
股骨骨摺%二燐痠鹽類%骨摺固定術,髓內%非典型骨摺
고골골절%이린산염류%골절고정술,수내%비전형골절
Femoral fractures%Diphosphonates%Fracture fixation,intramedullary%Atypical fractures
目的 探讨髓内固定治疗与长期服用双膦酸盐相关的非典型股骨骨折的疗效. 方法 回顾性分析2008年2月至2012年4月采用髓内固定治疗的21例(24侧骨折)与长期服用双膦酸盐相关的非典型股骨骨折患者资料,男2例,女19例；左侧10例,右侧8例,双侧3例；平均年龄为74.2岁(60 ～95岁)；从服药开始至出现骨折时间为58.6个月(37 ～95个月).15例(18侧骨折)由低能量损伤所致,6例无明显创伤.骨折部位:股骨转子下骨折1 3侧,股骨干骨折11侧.骨折AO分型均为32A2型.所有患者均于入院48 h内手术,股骨转子下骨折采用股骨长重建钉或长的股骨近端防旋髓内钉固定,股骨干骨折采用股骨髓内钉固定.术后观察患者的骨折愈合情况,末次随访时采用Thoresen评分标准评定患肢功能恢复情况. 结果 所有患者术后获平均2.0年(1.0～2.5年)随访.21例患者24侧骨折均获骨性愈合,平均愈合时间为5.1个月(3～8个月).末次随访时根据Thoresen评分标准评定患肢功能:优20侧,良3侧,可1侧,优良率为95.8％.无伤口感染、内固定物松动、断裂及骨折不愈合等并发症发生. 结论 髓内固定是治疗与长期服用双膦酸盐相关的非典型股骨骨折的有效方法.
目的 探討髓內固定治療與長期服用雙膦痠鹽相關的非典型股骨骨摺的療效. 方法 迴顧性分析2008年2月至2012年4月採用髓內固定治療的21例(24側骨摺)與長期服用雙膦痠鹽相關的非典型股骨骨摺患者資料,男2例,女19例；左側10例,右側8例,雙側3例；平均年齡為74.2歲(60 ～95歲)；從服藥開始至齣現骨摺時間為58.6箇月(37 ～95箇月).15例(18側骨摺)由低能量損傷所緻,6例無明顯創傷.骨摺部位:股骨轉子下骨摺1 3側,股骨榦骨摺11側.骨摺AO分型均為32A2型.所有患者均于入院48 h內手術,股骨轉子下骨摺採用股骨長重建釘或長的股骨近耑防鏇髓內釘固定,股骨榦骨摺採用股骨髓內釘固定.術後觀察患者的骨摺愈閤情況,末次隨訪時採用Thoresen評分標準評定患肢功能恢複情況. 結果 所有患者術後穫平均2.0年(1.0～2.5年)隨訪.21例患者24側骨摺均穫骨性愈閤,平均愈閤時間為5.1箇月(3～8箇月).末次隨訪時根據Thoresen評分標準評定患肢功能:優20側,良3側,可1側,優良率為95.8％.無傷口感染、內固定物鬆動、斷裂及骨摺不愈閤等併髮癥髮生. 結論 髓內固定是治療與長期服用雙膦痠鹽相關的非典型股骨骨摺的有效方法.
목적 탐토수내고정치료여장기복용쌍련산염상관적비전형고골골절적료효. 방법 회고성분석2008년2월지2012년4월채용수내고정치료적21례(24측골절)여장기복용쌍련산염상관적비전형고골골절환자자료,남2례,녀19례；좌측10례,우측8례,쌍측3례；평균년령위74.2세(60 ～95세)；종복약개시지출현골절시간위58.6개월(37 ～95개월).15례(18측골절)유저능량손상소치,6례무명현창상.골절부위:고골전자하골절1 3측,고골간골절11측.골절AO분형균위32A2형.소유환자균우입원48 h내수술,고골전자하골절채용고골장중건정혹장적고골근단방선수내정고정,고골간골절채용고골수내정고정.술후관찰환자적골절유합정황,말차수방시채용Thoresen평분표준평정환지공능회복정황. 결과 소유환자술후획평균2.0년(1.0～2.5년)수방.21례환자24측골절균획골성유합,평균유합시간위5.1개월(3～8개월).말차수방시근거Thoresen평분표준평정환지공능:우20측,량3측,가1측,우량솔위95.8％.무상구감염、내고정물송동、단렬급골절불유합등병발증발생. 결론 수내고정시치료여장기복용쌍련산염상관적비전형고골골절적유효방법.
Objective To investigate the efficacy of intramedullary nailing for atypical femoral fractures associated with long-term use of bisphosphonates.Methods A retrospective analysis was conducted of 21 patients with 24 atypical femoral fractures associated with long-term use of bisphosphonates who had been treated with intramedullary nailing from February,2008 to April,2012 in Queen Marry Hospital,Hong Kong.They were 2 men and 19 women,aged from 60 to 95 years (average,74.2 years).There were 10 left fractures,8 right ones and 3 bilateral ones.On average the fractures occurred 58.6 months (range,from 37 to 95 months) after using bisphosphonates.Six fractures had no history of trauma and 18 (in 15 patients) were caused by low-energy injury.There were 11 femoral diaphyseal fractures and 13 subtrochanteric femoral fractures,all AO 32A2.Within 48 hours after admission,the subtrochanteric femoral fractures were treated with long femoral reconstruction nails or long proximal femoral nail antirotation(PFNA) and the femoral diaphyseal fractures with intramedullary nails.Fracture union was observed postoperation and evaluated by the Thoresen system at the last follow-up.Results The average follow-up was 2.0 years (range,from 1.0 to 2.5 years).All the 24 fractures achieved bony union after an average time of 5.1 months (range,from 3 to 8 months).By Thoresen scoring,20 fi actures were excellent,3 good,and one fair,with an excellent to good rate of 95.8％.No operation-related complications occurred.Conclusion Intramedullary nailing is an effective treatment of atypical fractures associated with long-term use of bisphosphonates.
