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Safety and reliability of external fixation for basicervical and intertrochanteric fractures in high-risk elderly patients

机译:高危老年患者外固定架治疗股骨粗隆和股骨粗隆间骨折的安全性和可靠性

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摘要

Forty elderly patients with basicervical and pertrochanteric fractures were managed with uniplanar AO external fixator under regional anaesthetic block of the femoral nerve and lateral cutaneous nerve of the thigh from April 2003 to March 2006. The mean age of the patients was 67.9 ± 5.5 years. External fixator application was performed under radiological control after closed reduction had been obtained. Comorbid factors, duration of surgery, duration of hospitalisation, complications, walking ability, time to union and mortality rate were recorded. Patients were followed up for a mean period of 12 ± 4.5 months. Superficial pin tract infection occurred in 13 patients, healing in varus >10° and with shortening >2 cm occurred in six patients, and one patient suffered a spontaneous ipsilateral femoral neck fracture after removal of the fixator. The mean time for union was 10.4 ± 1.2 weeks. Rapid union rate and minor complications obtained in the present study are comparable to those obtained with standard internal fixation techniques. Minimal intraoperative blood loss, short operative time and early patient mobilisation are advantages signifying uniplanar external fixator application under regional anaesthetic block to be a viable option in treatment of basicervical and pertrochanteric fractures in high-risk elderly patients.
机译:从2003年4月至2006年3月,在单侧股神经和大腿外侧区域神经阻滞下,采用单平面AO外固定架治疗40例患有基本神经系统和转子粗隆骨折的老年患者。患者的平均年龄为67.9±5.5岁。获得闭合复位后,在放射线控制下进行外固定器的应用。记录合并症,手术时间,住院时间,并发症,步行能力,愈合时间和死亡率。对患者进行平均12±4.5个月的随访。浅表针道感染发生在13例患者中,六例患者的内翻愈合> 10°并缩短了> 2 cm,并且一例患者在移除固定器后发生了自发的同侧股骨颈骨折。工会的平均时间为10.4±1.2周。在本研究中获得的快速愈合率和较小的并发症与采用标准内固定技术获得的结果相当。术中出血量少,手术时间短和患者早期动员是优势,这表明在区域麻醉阻滞下单平面外固定架的应用是治疗高危老年患者基本神经和转子周骨折的可行选择。

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