Avtor/Urednik		Andoljšek, Matej; Rjazancev, Boris
Naslov		Necementna hemiartroplastika pri zlomu stegneničnega vratu. Zakaj ne? Novo modularno samovezno steblo izboljšuje rezultate necementnih hemiartroplastik
Prevedeni naslov		Uncemented hemiarthroplasty for a fracture of the femoral neck. Why not? A new modular self-tapping stem has improved the results of uncemented hemiarthroplasties
Tip		članek
Vir		Zdrav Vestn
Vol. in št.		Letnik 68, št. 2
Leto izdaje		1999
Obseg		str. 79-83
Jezik		slo
Abstrakt		Background. Uncemented hemiarthroplasty (HA) was found inferior to cemented HA in patients with a fracture of the femoral neck. A new modular self-tapping uncemented stem was used to improve the results of uncemented HA. In retrospective study of the two consecutive groups of patient the authors asked, whether the new stem has improved the results of uncemented hemiarthroplasty. Methods. In 72 fractures the new uncemented stem (Group - 1) and in 68 fractures cemented stem (Group - 2) were used. Between the two groups there were no significant differences in demographic characteristics, complications rates, rehabilitation efficiency, hospital stay and 3-, 6- as well as 12-months mortality. 82 patients (35 Group - 1, 47 Group - 2) have already died. Two patients, one from each group, were lost for follow-up. 56 patients (36 Group - 1,20 Group - 2) were questioned about pain and mobility. 56 fulfilled questionnaires were analysed according to Sikorski-Barrington's scale. Results. At a mean follow-up of 27+-10 months, 11 out of 36 patients from uncemented group were pain-free (grade 1), 13 had occasional and mild pain and did not need analgesics (grade 2), 8 had constant or occasional severe pain requiring analgesic occasionally (grade 3), and 4 patients had constant and severe pain requiring regular analgesics (grade 4). Corresponding figures for 20 patients from the cemented group were 6, 12, 1, and 1, but at a longer mean follow-up of 54+-12 months. After exclusion of 7 chair- and bed-bound patients (6 Group - 1, 1 Group - 2) from the analysis, the pain scores of the two studied groups were comparable with a median at grade 2 (p = 0.1816, Wilcoxon two-sample test), and the proportion of patients with pain (pain grade >1) was almost equal (70% versus 68.6%).(Abstract truncated at 2000 characters)
Izvleček		Izhodišča. Pri poškodovancih z zlomom stegneničnega vratu so bili rezultati necementnih hemiartroplastik (HA) slabši od rezultatov cementnih HA. Da bi izboljšali rezultate necementnih HA, so na kirurškem oddelku Splošne bolnišnice Jesenic razvili novo modularno samovrezno necementno steblo.V retrospektivni študiji je avtorja zanimalo, ali novo steblo izboljšuje rezultate necementnih HA. Metode. 72 zlomov stegneničnega vratu so oskrbeli z necementno protezo (Skupina - 1) in 68 zlomov s cementno protezo (Skupina - 2). Med skupinama ni bilo pomembnih razlik v demografskih značilnostih, številu zapletov, uspešnosti rehabilitacije, dolžini hospitalizacije, niti v 3-, 6- in 12-mesečni smrtnosti bolnikov. 82 bolnikov (35 iz Skupine - 1, 47 iz Skupine - 2) je umrlo. Dve bolnici, po ena iz vsake skupine, nista bili dosegljivi. 56 bolnikov (36 iz Skupine - 1, 20 iz Skupine - 2) je izpolnilo vprašalnik o bolečini in pomičnosti. 56 izpoljenih vprašalnikov sta avtorja analizirala s pomočjo Sikorski-Barringtonovih kriterijev. Rezultati. 11 od 36 bolnikov z necementno protezo operirani kolk ne boli, 13 bolnikov ima občasno in blago bolečino, zaradi katere ne potrebujejo analgetika, 8 jih ima stalno ali občasno hudo bolečino, zaradi katere občasno jemljejo analgetike, štirje bolniki imajo stalno in hudo bolečino, zaradi katere stalno jemljejo analgetike. ustrezne številke za cementno skupino so 6, 12, 1 in 1, vendar ob daljši opazovalni dobi (Skupina - 1:27+-10 mesecev, Skupina - 2:54+-12 mesecev). Potem ko so bili iz analize izključeni z invalidskim vozičkom pomični in nepomični bolniki (6 iz Skupine - 1 in 1 iz Skupine - 2), statistično pomembnih razlik v oceni bolečine med skupinama ni bilo (p = 0,01816, Wilcoxonov test).(Izvleček prekinjen pri 2000 znakih)
Deskriptorji		FEMORAL NECK FRACTURES HIP PROSTHESIS TREATMENT OUTCOME