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31.
Javier Alegre-López José Cordero-Guevara José L. Alonso-Valdivielso Julia Fernández-Melón 《Osteoporosis international》2005,16(7):729-736
Hip fracture results in excess mortality and functional disability. This study sought to identify predictors of mortality and limited functional ability 1 year after hip fracture. We conducted a 1-year follow-up of a prospective population-based inception cohort of 218 hip fracture patients who had been consecutively admitted and discharged from hospital during the previous year. Mortality was observed to be independently associated with poor mental status (relative risk [RR]=6.96; 95% confidence interval [95% CI], 1.73–28.00), prefracture limited functional ability (RR=4.35; 95% CI, 1.32–14.36), institutionalized disposition at discharge (RR=2.92; 95% CI, 1.02–8.38), and male gender (RR=2.44; 95% CI, 1.01–5.93). Independent predictors of limited functional ability were prefracture functional disability (RR=34.14; 95% CI, 3.13–372.33), poor mental status (RR=9.71; 95% CI, 1.57–59.82), age >80 years (RR=4.03; 95% CI, 1.48–11.00), and female gender (RR=3.57; 95% CI, 0.08–0.98). On discharge, special attention and care should thus be given to all patients displaying any of the above predictive factors. 相似文献
32.
P. Rossi F. Castoldi R. Rossi F. Caranzano M. Baronetti F. Dettoni 《Journal of orthopaedics and traumatology》2007,8(3):157-163
Surgery passes through a continuous evolution, thanks to the introduction of new technologies and techniques. Tissue-sparing
surgery is a concept introduced in the last years to address prosthetic surgery to a more conservative fashion. We discuss
the TSS decalogue with a critical eye, pointing out how traditional surgery is evolving in accordance with TSS statements.
Proceedings of the Consensus Conference “TSS in hip and knee replacement”, Rapallo, Italy, 22–24 June 2006 相似文献
33.
老年新鲜股骨颈骨折治疗方法探讨 总被引:1,自引:0,他引:1
目的 探讨老年新鲜股骨颈骨折的术式选择。方法 回顾性分析217例60岁以上新鲜股骨颈骨折,分别采用单钉固定(46例)、多针固定(37例)、AO空心钉固定(79例)、人工髋关节置换(55例)4种方法,对比骨折愈合率、股骨头坏死率、髋关节功能恢复优良率。结果 内固定组骨折愈合率83.3%(140/162),股骨头坏死率19.1%(31/162),髋关节功能优良率75.9%(123/162)。其中空心钉组骨折愈合率94.9%(75/79),股骨头坏死率6.3%(5/79),髋关节功能优良率91.1%(72/79)。人工关节组髋关节功能优良率89.1%(49/55)。结论 内固定手术对老年新鲜股骨颈骨折有意义,AO空心钉固定操作简单,骨折愈合率高,可作首选内固定。人工髋关节置换应严格掌握适应证。 相似文献
34.
目的研究创伤性复发性腓骨肌腱脱位的手术方法. 方法回顾分析1986年1月~2003年12月手术治疗的21例创伤性复发性腓骨肌腱脱位的病例,所有病例均应用Watson Jones手术. 结果 15例得到随访,随访时间1~15年,平均4.9年.1例因外伤再次脱位,其余14例未再出现脱位,均恢复正常运动或训练,比赛. 结论 Watson Jones手术治疗复发性脱位操作简单,损伤小,效果满意. 相似文献
35.
V. Lenin Babu K. Baskaran 《European journal of orthopaedic surgery & traumatology : orthopedie traumatologie》2005,15(2):148-150
We report the case of a 20-year-old man with an ipsilateral mid-third clavicle fracture with grade V acromioclavicular joint (ACJ) dislocation. The combination of these two injuries is rare. A literature search produced various treatment algorithms. In this case, the patient was successfully treated with a Bosworth screw.This work was carried out in the Department of Orthopaedics, William Harvey Hospital, Ashford, Kent, UK 相似文献
36.
37.
[目的]探讨儿童先天性髋关节脱位的股骨和骨盆联合手术中洗涤式自体血液回收的应用方法与前景。[方法]2003年8月~2005年12月,17例先天性髋关节脱位股骨和骨盆联合手术中,使用Cell Saver 5血液回收系统行术中的血液回收。观察回输自体血液后的并发症发生情况,记录术中估计失血量、实际回收血量,以及回输血前后的Hb、Hct、P lt、PT、APTT、HR、BP、SPO2等的变化情况。[结果]17例患儿术中血液回收总量2 090 m l,平均每人(171±53)m l。其中4例出现一过性血红蛋白尿,其他无并发症。患者术前和术后24 h的Hb、Hct、HR比较差异有显著性意义(P<0.01);患者术前和术后24 h的P lt、PT、APTT、SPO2、BP比较差异无显著性意义(P>0.05)。[结论]儿童先天性髋关节脱位的股骨和骨盆联合手术中的血液回收是安全、有效的自体输血方式,明显节约异体血的用量,有效避免血液传播性疾病的发生。 相似文献
38.
39.
小儿先天性髋关节脱位近年来应用术式的演变及其评估 总被引:5,自引:2,他引:3
本文介绍本院近4年来小儿先天性髋脱位治疗应用术式的演变。由20多年来一直喜欢用骨盆截骨术演变为近1年来用得最多的是造盖术。近4年共手术463例,565髋。实践证明:比起骨盆截骨术,造盖术显得更简便,侵袭小,不需二次手术拔除内固定针。因在我国大龄髋脱位偏多,造盖术更适合我国国情。经过一些改进,可以克服造盖折断和吸收问题。 相似文献
40.
D. Thiébaud P. Burckhardt M. Costanza D. Sloutskis D. Gilliard F. Quinodoz A.-F. Jacquet B. Burnand 《Osteoporosis international》1997,7(5):457-462
The relative importance of vitamin D deficiency, secondary hyperparathyroidism, nutritional deficiency and low bone mineral
density (BMD) as risk factors for hip fracture is not definitely established. In the framework of a case-control study of
risk factors for hip fractured, biochemical markers of bone metabolism and nutrition and femoral BMD data were compared in
136 female and 43 male hip fracture patients, 126 female and 44 male age-matched hospitalized controls, and 47 healthy elderly
women (8 men). Patients with hip fracture had lower albumin (−10%9 and 25(OH)-vitamin D (25(OH)D; −19%) compared with hospitalized
controls, and lower albumin (−28%) and 25(OH)D levels (−52%) compared with the elderly controls. Serum values of IGFBP-3 were
also significantly lower (−33%) in hip fracture patients than in community controls. BMD of femoral neck was lower (p < 0.001) in patients than in hospitalized and community controls. In hip fracture patients, parathyroid hormone (PTH) correlated
weakly with BMD (neck: r = −0.19, trochanter: r = −0.17; both p < 0.05). When all women were pooled (n = 233), albumin correlated significantly (age-adjusted) with BMD at all sites (neck: r = 0.27, trochanter: r = 0.25; all p < 0.001). Albumin, but not 25(OH)D, also correlated with skinfold thickness (r = 0.19, p < 0.0025) and with body mass index (BMI) (r = 0.14, p < 0.05). Male patients with hip fracture had lower BMD and albumin (both p < 0.001), 25(OH)D (p = 0.02) and IGFBP-3 levels (p <: 0.005) compared with the controls. When male patients and controls were pooled together, albumin, skinfold thickness and
BMI were significantly correlated with each other, but not with BMD. IGFBP-3 was highly correlated with albumin (p < 0.0001), 25(OH)D (p < 0.005) and, less significantly, with PTH (p < 0.05), but not with BMI or skinfold thickness. IGFBP-3 was significantly correlated with BMD at all sites (neck: r = 0.27, p < 0.05); trochanter: r = 0.40, p < 0.0005). In conclusion, low albumin and low BMD were both important risk factors for hip fracture. Low serum albumin was
the strongest independent variable correlated with hip fractures. In men, IGFBP-3 was correlated with BMD. The femoral BMD
depended only weakly on PTH and 25(OH)D, but was correlated at all sites with albumin, a non-specific parameter of nutrition
and general health. 相似文献