Résumé
Objective@#To explore the effect of obesity on the treatment for femoral neck fracture in patients with SuperPATH hip replacement.@*Methods@#Seventy patients who were treated with SuperPATH hip replacement in the Second People's Hospital of Wuxi from January 2014 to January 2017 were selected in the study.Based on their body mass index(BMI), the patients were divided into obesity group(BMI≥30kg/m2) (23 cases), overweight group(BMI: 25-30kg/m2) (22 cases), and normal group(BMI: 18.5-25kg/m2)(25 cases). The incision length, operation time, blood loss, blood transfusion rate, pain score, hip joint function score, imaging measurement results and postoperative complications were compared among the three groups.@*Results@#All 70 patients received the operation successfully.The incision length of the obesity group was (7.4±0.2)cm, which of the overweight group was (7.2±0.1)cm, which of the normal group was (7.1±0.8)cm, the difference among the three groups was statistically significant (F=24.671, P<0.001). The patients were followed up for 9-13 months.The acetabular anteversion angle, acetabular abduction angle, pain score, mobility of hip joint, walking ability score in the obesity group were (17.8±1.2)°, (40.9±3.4)°, (1.26±0.61)points, (95.43±7.89)°, (8.10±0.27)points, respectively, which in the overweight group were (16.7±3.3)°, (42.9±2.9)°, (1.23±0.58)points, (96.78±3.22)°, (8.20±0.92) points, respectively, which in the normal group were (15.8±2.7)°, (43.9±5.1)°, (1.24±0.78)points, (97.12±6.44)°, (8.20±0.48)points, respectively.The difference of acetabular abduction angle among the three groups was statistically significant (F=9.803, P=0.002). In the obesity group, there were two cases of incision infection, two cases of deep venous thrombosis and one case of pulmonary complication, the incidence rate of complications was 5%.In the overweight group, there was one case of superficial incision infection, and one case of deep vein thrombosis, the incidence rate of complications was 2%.In the normal group, there was one case of deep venous thrombosis, the incidence rate of complications was 1%.The difference of incidence rate of complications among the three groups was statistically significant(χ2=15.31, P<0.01).@*Conclusion@#Obesity increases the surgical risk of SuperPATH total hip replacement, and more attention should be attached to perioperative and post-operative treatment for such patients.
Résumé
Objective To explore the effect of obesity on the treatment for femoral neck fracture in patients with SuperPATH hip replacement.Methods Seventy patients who were treated with SuperPATH hip replacement in the Second People's Hospital of Wuxi from January 2014 to January 2017 were selected in the study.Based on their body mass index(BMI),the patients were divided into obesity group(BMI ≥30kg/m2) (23 cases),overweight group (BMI:25-30kg/m2) (22 cases),and normal group(BMI:18.5-25kg/m2) (25 cases).The incision length,operation time,blood loss,blood transfusion rate,pain score,hip joint function score,imaging measurement results and postoperative complications were compared among the three groups.Results All 70 patients received the operation successfully.The incision length of the obesity group was (7.4 ± 0.2) cm,which of the overweight group was (7.2 ±0.1) cm,which of the normal group was (7.1 ± 0.8) cm,the difference among the three groups was statistically significant (F =24.671,P ＜ 0.001).The patients were followed up for 9-13 months.The acetabular anteversion angle,acetabular abduction angle,pain score,mobility of hip joint,walking ability score in the obesity group were (17.8 ± 1.2) °,(40.9 ± 3.4) °,(1.26 ± 0.61) points,(95.43 ± 7.89) °,(8.10 ± 0.27) points,respectively,which in the overweight group were (16.7 ± 3.3) °,(42.9 ± 2.9) °,(1.23 ± 0.58) points,(96.78 ± 3.22) °,(8.20 ±0.92) points,respectively,which in the normal group were (15.8 ± 2.7) °,(43.9 ± 5.1) °,(1.24 ± 0.78) points,(97.12 ± 6.44)°,(8.20 ± 0.48)points,respectively.The difference of acetabular abduction angle among the three groups was statistically significant (F =9.803,P =0.002).In the obesity group,there were two cases of incision infection,two cases of deep venous thrombosis and one case of pulmonary complication,the incidence rate of complications was 5％.In the overweight group,there was one case of superficial incision infection,and one case of deep vein thrombosis,the incidence rate of complications was 2％.In the normal group,there was one case of deep venous thrombosis,the incidence rate of complications was 1％.The difference of incidence rate of complications among the three groups was statistically significant (x2 =15.31,P ＜ 0.01).Conclusion Obesity increases the surgical risk of SuperPATH total hip replacement,and more attention should be attached to perioperative and post-operative treatment for such patients.
Résumé
Objective@#To explore the treatment of senile osteoporotic femoral fractures after using internal fixation of bone cement dry prosthetic.@*Methods@#Twelve patients aged from 74 to 94 years with mean age of (84.0±2.5) years with internal fixation of bone cement dry prosthetic surgery who were treated at Department of Orthopaedics in Nanjing Medical University Affiliated Wuxi Second Hospital between May 2013 and May 2015 were retrospectively analyzed. There were 8 male and 4 female, 10 cases of tumble and 2 cases of traffic injury. The fracture types with AO type included 1 case of A1 type, 5 cases of A2 type, 3 cases of A3 type, 1 case of B1 type, 2 cases of B2 type. The steel plate internal fixation with bone cement dry prosthetic method was chosen to treat senile severe femoral fracture. Postoperative observation of postoperative pain assessment, hip joint activity and walking ability were evaluated. Paired simple t test and Wilcoxon rank sum test were used to compare the differences of pain score and the ability to walk.@*Results@#Twelve cases received an average of (16.0±3.6) months follow-up. The average hospitalization days are (9.0±1.4) days and average of intraoperative time was (68.0±10.6) minutes. Intraoperative blood loss compared to normal was (106.0±24.2) ml. Patients began walking load and activities in two weeks. The gait and joint activities gradually restored and there were no obvious deformity and no loose internal fixation. All of the patients didn′t have fracture shift with breaking plates or screws deformation and have no bone cement reaction. The walking ability was (4.1±0.9) points, the hip joint activities were 98.5°±7.7° and pain scores were 1.22±0.58 by Holden grading standards. The differences of walking ability (Z=-3.126, P<0.05) and pain scores (t=23.047, P<0.001) between pre- and post-operative were statistically significant. One patient had contralateral hip pain, 2 patients had lateral thigh pain, 10 patients returned to preoperative level of activity. Postoperative function recovered satisfactorily, there were statistically differences.@*Conclusion@#The treatment of severe osteoporosis fractures by internal fixation with bone cement dry prosthetic is a new and effective method, making patients less pain, improving joint function and walking ability.