动态髋螺钉治疗股骨粗隆间骨折术后早期Harris髋关节评分的测量

Esculapio Pub Date : 2023-11-08 DOI:10.51273/esc23.25131933
Muhammad Umar Khan, Omer Khalid Farooq, Asif Khan, Tariq Aziz, Waseem Akbar, Faisal Nazeer Hussain
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摘要

目的:股骨粗隆间骨折是一种难以重建的骨折,由于其强大的生物力学力导致许多植入物设计失败。经过多次设计失败后,动态髋螺钉(DHS)经受住了时间的考验。我们使用Harris髋关节评分对60例患者进行了为期24周的骨折功能恢复的前瞻性研究。Harris髋关节评分用于测量结果。材料和方法:这是一个描述性病例系列,于2022年3月15日至2023年1月14日在拉合尔阿维森纳医院骨科完成。选取60例年龄≥50岁的股骨粗隆间骨折患者进行描述性研究,采用Harris髋关节评分法对术后6个月的康复情况进行研究。排除同肢其他骨折或多处骨折患者、BMI 35.0kg/m2、糖尿病患者(BSR 200 mg/dl)、既往有症状性髋臼疾病患者、既往有卒中、偏瘫或其他可能干扰平稳康复的神经肌肉疾病患者。术后12周、20周、24周随访。每次就诊均进行双翼x光检查,对患者进行面谈并计算Harris髋关节评分。最后根据Harris髋关节评分将功能结果分为优、良、一般和差。结果:60例患者中,男性20例(33.33%),女性40例(66.67%)。平均年龄61.40±5.97岁。平均骨折时间8.05±2.51个月。在我们的研究中,63.33%的患者功能预后为优,26.67%为良,5.0%为一般,5.0%为差。Harris髋关节平均评分为88.40±7.91。结论:Harris髋关节评分可用于评估DHS治疗股骨粗隆间骨折患者术后早期的康复情况。
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Measurement of Harris Hip Scoring During Early post-operative Period in Intertrochanteric Fractures FemurTreated with Dynamic Hip Screw
Objectives: Intertrochanteric fractures of femur are difficult fractures to reconstruct because of strong biomechanical forces leading to failure of many an implant designs in the past. After failure of many designs Dynamic Hip Screw (DHS) has stood the test of time. We have prospectively studied the functional recovery of these fractures in 60 patients for 24weeks using Harris Hip scores. Harris hip score was used to measure the outcome. Material and Methods: It was a descriptive case series done between 15th March 2022 to 14 January2023 in Department of Orthopedics Surgery, Avicenna Hospital, Lahore. Sixty patients of intertrochanteric fractures within 2weeks ofinjury of age≥50 yearswere inducted in a descriptive study and Harris Hip Score was used to study the rehabilitation during 6 months after surgery. Patients with other fractures of same limb or multiple fractures, BMI >35.0kg/m2, or diabetic (BSR >200 mg/dl), patients with pre-existing symptomatic acetabular diseases, patient with previous stroke, hemiparesis or other neuromuscular disorder likely to interfere with uneventful rehabilitation were excluded. Patients were were followed-up in OPD after 12, 20 and 24 weeks of surgery. On each visit biplane X-rays were made, patient was interviewed and Harris hip score was calculated. In the end according to Harris hip score, functional outcome was categorized as excellent, good, fair and poor outcomes. Results: Out of these 60 patients, 20 (33.33%) were male and 40 (66.67%) were female. Mean age was 61.40 ± 5.97 years. Mean duration of fracture was 8.05 ± 2.51 months. In ourstudy, functional outcome was excellent in 63.33%, good in 26.67%, fair in 5.0% and poor in 5.0% cases. Mean Harris hip score was 88.40 ± 7.91. Conclusion: Harris hip score can be used to assess rehabilitation of patients treated with DHS for intertrochanteric fractures in early post operative period.
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