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首页> 外文期刊>Open Journal of Urology >Indications and Results of Surgical Treatment of Proximal Femoral Fractures in Adults at Ouagadougou
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Indications and Results of Surgical Treatment of Proximal Femoral Fractures in Adults at Ouagadougou

机译：瓦加杜古成人股骨近端骨折的手术治疗适应症和结果

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Background: Functional treatment of proximal femur fractures (PFF) is being discontinued with advances in surgery and anesthesia. Suspension traction is used as a waiting treatment before surgery when technical, material and financial conditions are not met. The surgical treatment of these fractures must ensure a stable reduction and fixation, to allow early support to the patient who will quickly regain his previous autonomy. Objective: To specify the indications for surgical treatment of proximal fractures in adult in order to evaluate the results in the context of Burkina Faso. Patients and Methods: We conducted a retrospective study including adult patients hospitalized and followed up for proximal femoral fracture (PFF) in the orthopedic-traumatology department of the Yalgado Ouedraogo University Hospital Center at Ouagadougou. Among 310 patients presenting with PFF in 5.5 years, (56 cases a year (10.4%)), we focused on those whose PFFs were treated by surgical methods and followed up. Patients treated with orthopedic (40.1%) or functional (6.8%) methods, patients with incomplete records and those having signed a discharge against medical advice were excluded. A total of 94 patients, with 95 PFFs treated by surgical methods, constituted our study population. Road traffic accidents (51.1%) and domestic accidents (48.9%) were the predominant etiologies. The functional criteria of Postel Merle d’Aubigné (PMA) were used for the evaluation of the results (Table 1). Results: A total of 65 men and 29 women (sex ratio 2.2), aged of average 56 years, were recorded. Trochanteric mass fractures were predominant with 63 cases (66.3%), including one case of bilateral fracture and one case of an open fracture; we also reported 32 femoral neck fractures (33.7%). Osteosynthesis was performed in 66 patients (70.2%) and hip arthroplasty in the remaining 28 patients (29.8%). Osteosynthesis with DHS plate screws was performed in 49 cases (73.1%) and Moore type cephalic arthroplasty in 18 cases (64.3%). Two patients (2.1%) died, one in shock state and the second by pulmonary embolism. The main complications were 3 superficial infections (3.16%), 10 painful coxitis (35.7%) and one pseudarthrosis (dismantling of the material). Despite these complications, functional outcomes were satisfactory in 88.7%, poor in 9.7% and fair in 1.6%. Conclusion: Surgical treatment of proximal femoral fractures allows early removal and rapid functional rehabilitation; which improves functional outcomes and increases the quality of life in elderly patients.
机译：背景：随着外科手术和麻醉的进展，股骨近端骨折（PFF）的功能性治疗已停止。如果技术，材料和财务状况均未达到要求，则悬吊牵引术可在手术前用作等待治疗。这些骨折的手术治疗必须确保稳定的复位和固定，以便为患者提供早期支持，从而使患者能够迅速恢复其先前的自主性。目的：为布基纳法索评估成人近端骨折的手术指征，以评估其结果。患者和方法：我们进行了一项回顾性研究，其中包括在瓦加杜古的Yalgado Ouedraogo大学医院中心的骨伤科部门住院治疗的成人患者，并对这些患者进行了股骨近端骨折（PFF）随访。在5.5年中出现PFF的310例患者中（每年56例（10.4％）），我们重点研究了通过手术方法治疗并随访了PFF的患者。排除了使用骨科（40.1％）或功能性（6.8％）方法治疗的患者，记录不完整的患者以及根据医疗建议签署出院的患者。共有94例患者接受了95例PFF的手术治疗，构成了我们的研究人群。主要的病因是道路交通事故（51.1％）和家庭事故（48.9％）。 Postel Merle d'Aubigné（PMA）的功能标准用于评估结果（表1）。结果：总共记录了65名男性和29名女性（性别比2.2），平均年龄为56岁。股骨转子骨骨折占63例，占66.3％，其中双侧骨折1例，开放性骨折1例。我们还报告了32例股骨颈骨折（33.7％）。 66例（70.2％）进行了骨固定，其余28例（29.8％）进行了髋关节置换术。用DHS螺钉固定骨固定49例（占73.1％），进行摩尔型头置换术18例（占64.3％）。两名患者（2.1％）死亡，一名处于休克状态，另一名则因肺栓塞死亡。主要并发症为3例表面感染（3.16％），10例疼痛性结肠炎（35.7％）和1例假关节（材料拆解）。尽管有这些并发症，功能转归仍令人满意，为88.7％，差于9.7％，尚可1.6％。结论：股骨近端骨折的手术治疗可及早切除并快速恢复功能。改善了功能结果并提高了老年患者的生活质量。

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