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首页> 外文期刊>Geriatric orthopaedic surgery & rehabilitation. >Outcomes for Elderly Patients With Atypical Femoral Fractures Compared to Typical Femoral Fractures for Length of Stay, Discharge Destination, and 30-Day Mortality Rate
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Outcomes for Elderly Patients With Atypical Femoral Fractures Compared to Typical Femoral Fractures for Length of Stay, Discharge Destination, and 30-Day Mortality Rate

机译：老年人患者的成果与典型的股骨骨折相比，保持典型的股骨骨折，排放目的地和30天死亡率

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Introduction: Despite increasing recognition of atypical femoral fractures (AFFs), there’s conflicting evidence about incidence, aetiology, and short-term outcomes of these injuries. This study reports the incidence of AFFs at our center and compares the early postoperative outcomes against typical femoral fractures (TFFs). Methods: A retrospective observational cohort study of patients presenting to our trauma unit between November 2015 and July 2016 was undertaken. Inclusion criteria required radiologically confirmed proximal femoral fracture, which was then categorized as AFF or TFF. Primary outcome measures included length of stay, discharge destination, and 30-day mortality. Results: Two hundred thirty-nine patients presented to our trauma unit over 9 months with either a fractured neck of femur or proximal femoral fracture. A total of 122 were identified as pertrochanteric, subtrochanteric, or proximal femoral shaft fractures of which 25 (20.5%) displayed atypical radiographic features consistent with AFF. The 2 groups were similar for average age (TFF 85.3 years vs AFF 85.0 years), gender (19% vs 16% male gender), American Society of Anaesthesiology grade (3.0 vs 3.0), cognitive score (abbreviated mental test score = 7.03 vs 7.08), and preinjury place of residence (88.9% vs 92.0% lived in own home). Typical fractures were fixed with either dynamic hip screw or intramedullary nailing, all atypical fractures were fixed with intramedullary nailing. There was no statistical difference between the 2 groups for length of stay (12.8 days vs 14.3 days; P .05), discharge to preinjury residence (45.1% vs 36%; P .05), or 30-day mortality (8.1% vs 12%; P .05). Discussion: In our predominantly geriatric population atypical radiographic features were observed in around 10% of patients presenting with proximal femoral fractures or fractured neck of femur. Previous studies have reported poor outcomes for pain, mobility, and length of stay after AFF. However, we observed no difference in short-term outcome measures when compared to patients with typical proximal femoral fracture patterns at our trauma unit. Conclusion: With modern principles of trauma care outcomes achieved following AFFs may be equivalent to typical femoral fractures in the geriatric population.
机译：介绍：尽管对非典型股骨骨折（AFFS）的认可越来越苛刻（AFFS），但有关这些伤害的发病率，病毒学和短期结果的矛盾的证据。本研究报告了我们中心有害的发病率，并比较了对典型股骨骨折（TFF）的早期术后结果。方法：对2015年11月至7月7日至7月7日之间的患者的回顾性观察队列研究。包含放射学证实的近端股骨骨折所需的含有标准，然后将其分类为AFF或TFF。主要结果措施包括逗留时间，排放目的地和30天死亡率。结果：两百三十九名患者在9个月内呈现给我们的创伤单元，股骨骨折或近端股骨骨折。总共122例被鉴定为pertrochantoric，子系统或近端股骨轴骨折，其中25（20.5％）显示的非典型射线照相特征一致。这2组的平均年龄相似（TFF 85.3岁vs 85.0岁），性别（19％与16％的男性性别），美国麻醉学级（3.0 Vs 3.0），认知得分（缩写心理测试得分= 7.03 vs 7.08），居住的居住地（88.9％VS 92.0％在自己的家中）。用动态髋螺钉或髓内钉固定典型的骨折，所有的非典型骨折都用髓内钉固定。 2组之间没有统计学差异，持续时间长（12.8天与14.3天; P> .05），排放到前居住住宅（45.1％vs 36％; p> .05），或30天死亡率（8.1 ％vs 12％; p> .05）。讨论：在我们主要在患有近端股骨骨折或股骨骨折颈部患者的患者中观察到大量老年人群体非典型放射学特征。以前的研究报告了痛苦，流动性和留下后的逗留时间不佳。然而，与我们的创伤单位的典型近端股骨骨折模式相比，我们观察到短期结果措施的差异。结论：凭借逐步达到的创伤护理结果，可能相当于老年人群中典型的股骨骨折。

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