Abstract：
BACKGROUND: Fractures of the distal femoral third are an important cause of morbidity and mortality, and their treatment is currently controversial.
OBJECTIVE: To compare the results between minimally invasive techniques versus exposure of the fracture site. Secondly, to evaluate the relationship between demographic factors, mechanism of injury and surgical delay with patient prognosis.
METHODS: Retrospective cohort study carried out between 2015 and 2021 in a tertiary hospital. Data collection was performed by reviewing medical histories, measuring demographic and hospital parameters and definitive treatment strategy. One year of follow-up was completed in all patients, assessing the occurrence of surgical complications and mortality. A stratified analysis of the variables of interest was performed among patients over 65 years of age.
RESULTS: 128 fractures were recorded, with definitive osteosynthesis being performed in 117. Patients who underwent minimally invasive techniques required a shorter hospital stay (9 [7-12] vs. 12 [8.75-16] days) (p=0.007), with no differences in mortality or complications during follow-up. In those over 65 years of age, opening the fracture site was associated with an increased risk of infection compared to minimally invasive techniques (33.3% vs. 2%) (p=0.507). All the deceased were patients over 65 years of age (33.7% at one year). Surgical delay longer than 48h increased mortality by 10% among those older than 65 years (p=0.3). High-energy trauma had a higher proportion of pseudarthrosis (27.6% vs. 6.1%) (p=0.011).
CONCLUSIONS: Minimally invasive techniques decreased hospital stay but not complications or long-term mortality.
METHODS: IIb.
OBJECTIVE: To compare the results between minimally invasive techniques versus exposure of the fracture site. Secondly, to evaluate the relationship between demographic factors, mechanism of injury and surgical delay with patient prognosis.
METHODS: Retrospective cohort study carried out between 2015 and 2021 in a tertiary hospital. Data collection was performed by reviewing medical histories, measuring demographic and hospital parameters and definitive treatment strategy. One year of follow-up was completed in all patients, assessing the occurrence of surgical complications and mortality. A stratified analysis of the variables of interest was performed among patients over 65 years of age.
RESULTS: 128 fractures were recorded, with definitive osteosynthesis being performed in 117. Patients who underwent minimally invasive techniques required a shorter hospital stay (9 [7-12] vs. 12 [8.75-16] days) (p=0.007), with no differences in mortality or complications during follow-up. In those over 65 years of age, opening the fracture site was associated with an increased risk of infection compared to minimally invasive techniques (33.3% vs. 2%) (p=0.507). All the deceased were patients over 65 years of age (33.7% at one year). Surgical delay longer than 48h increased mortality by 10% among those older than 65 years (p=0.3). High-energy trauma had a higher proportion of pseudarthrosis (27.6% vs. 6.1%) (p=0.011).
CONCLUSIONS: Minimally invasive techniques decreased hospital stay but not complications or long-term mortality.
METHODS: IIb.
摘要：
背景：股骨远端三分之一骨折是发病率和死亡率的重要原因，他们的治疗目前是有争议的。
目的：比较微创技术与骨折部位暴露的结果。其次,为了评估人口因素之间的关系，损伤和手术延迟与患者预后的机制。
方法：回顾性队列研究于2015年至2021年在三级医院进行。通过回顾病史进行数据收集，测量人口统计学和医院参数和确定的治疗策略。所有患者都完成了一年的随访，评估手术并发症的发生和死亡率。对65岁以上的患者进行了感兴趣变量的分层分析。
结果：记录了128处骨折，在117年进行确定性骨合成。接受微创技术的患者需要较短的住院时间（9[7-12]vs.12[8.75-16]天)(p=0.007)，随访期间死亡率或并发症无差异。在65岁以上的人中，与微创技术相比，打开骨折部位与感染风险增加相关(33.3%vs.2%)(p=0.507)。所有死者均为65岁以上的患者（一年中为33.7％）。在65岁以上的人群中，手术延迟超过48小时的死亡率增加了10％（p=0.3）。高能量创伤的假关节比例较高（27.6%vs.6.1%)(p=0.011)。
结论：微创技术减少了住院时间，但没有并发症或长期死亡率。
方法：IIb。
目的：比较微创技术与骨折部位暴露的结果。其次,为了评估人口因素之间的关系，损伤和手术延迟与患者预后的机制。
方法：回顾性队列研究于2015年至2021年在三级医院进行。通过回顾病史进行数据收集，测量人口统计学和医院参数和确定的治疗策略。所有患者都完成了一年的随访，评估手术并发症的发生和死亡率。对65岁以上的患者进行了感兴趣变量的分层分析。
结果：记录了128处骨折，在117年进行确定性骨合成。接受微创技术的患者需要较短的住院时间（9[7-12]vs.12[8.75-16]天)(p=0.007)，随访期间死亡率或并发症无差异。在65岁以上的人中，与微创技术相比，打开骨折部位与感染风险增加相关(33.3%vs.2%)(p=0.507)。所有死者均为65岁以上的患者（一年中为33.7％）。在65岁以上的人群中，手术延迟超过48小时的死亡率增加了10％（p=0.3）。高能量创伤的假关节比例较高（27.6%vs.6.1%)(p=0.011)。
结论：微创技术减少了住院时间，但没有并发症或长期死亡率。
方法：IIb。
