高齢者大腿骨頚部骨折手術の手術待機期間と術後成績および周術期合併症の検討

The Correlation of the Timing of Surgery Between Functional Results and Perioperative Complications in Senile Femoral Neck Fractures

　高齢者大腿骨頚部骨折の待機日数と術後合併症について検討した．対象は2001年1月から2004年2月までに手術した70歳以上の大腿骨頚部骨折患者215名で，手術は症例に応じて選択した．待機日数を受傷当日，翌日手術の準緊急群（111名），それ以降の待機群（104名）に分類した．両群間において性別，年齢，既往症について差はなかった．術後合併症，入院期間，術前後歩行能力について調査した．術後不穏・譫妄は準緊急群で増加したが，有意差は認めなかった．合併症発生頻度と術後歩行能力に差はなかったが，入院期間は準緊急群で有意に短かった．

　We evaluated the correlation of the timing of surgery and postoperative complications in 215 patients over the age of 70 years with femoral neck fractures. We performed compression hip screw fixation, intramedullary hip screw nailing, femoral head prosthetic replacement and internal fixation with cannulated screw. Two hundred and fifteen patients were divided into two groups according to the interval between the fracture and surgery. One hundred and eleven patients were operated upon within two days of injury and 104 patients were operated upon after this period of time. There were no significant differences in the incidence of complications and postoperative walking ability between the two groups. The length of hospitalization in the early surgery group was statistically much shorter than the later surgery group. The incidence of postoperative confusion increased in the early surgery group, though it was not considered to be statistically significant. We should pay attention to the possibility of postoperative confusion with early surgery patients.