摘要
目的探讨人工股骨头置换术治疗高龄股骨颈骨折发生假体周围骨折的相关危险因素。方法回顾性分析2013年1月至2016年6月期间行人工股骨头置换术的120例80岁及以上股骨颈骨折患者资料。男45例，女75例；平均年龄为85．2岁（80—97岁）；骨折Garden分型：Ⅲ型72例，Ⅳ型48例；受伤至手术时间平均为5．1d。根据术中及术后随访期间是否发生假体周围骨折将患者分为骨折组和无骨折组，比较两组患者的一般资料。对影响假体周围骨折的各因素进行多因素logistic回归分析。结果120例患者术后获平均26．1个月（13～48个月）随访。共11例患者发生假体周围骨折，发生率为9．2％（11／120）。与无骨折组比较，骨折组患者的年龄更大，既往骨折发生率更高，生物型假体类型更多，美国麻醉医师协会分级更严重，差异均有统计学意义（P〈0．05）；而两组患者的其他一般资料比较差异均无统计学意义（P〉0．05）。多因素logistic回归分析结果显示：高龄[OR=1．268，95％CI（1．059，1．517），P=0．0101、生物型假体IOR=0．072，95％CI（0．008，0．625），P=0．017]是假体周围骨折的独立危险因素。结论人工股骨头置换术治疗高龄股骨颈骨折患者发生假体周围骨折的风险较高。高龄和置换类型中生物型假体是影响假体周围骨折的独立危险因素。
Objective To analyze the risk factors associated with periprosthetic femoral fracture following hemiarthroplasty （HA） for displaced femoral neck fracture in aged patients. Methods From January 2013 to June 2016, 120 patients over 80 years old were treated by HA for displaced femoral neck fractures. They were 45 males and 75 females, with an average age of 85. 2 years （from 80 to 97 years） . Their fractures were Garden type m （72 cases） and Garden type 1V （48 cases）. The time from injury to op- eration averaged 5.1 days. The patients were divided into a fracture group and a non-fracture group according to the presence or absence of the periprosthetic fracture. The general data of the 2 groups were compared; multivariate logistic regression analyses were done to indentify the influencing factors associated with periprosthetic femoral fracture. Results The 120 patients obtained a mean follow-up of 26. 1 months （from 13 to 48 months）. Periprosthetic femoral fracture occurred in 11 cases, giving an overall incidence of 9. 2% （11/120）. Compared with the non-fracture group, the average age was significantly older, the inci- dence of past fractures was significantly higher, significantly more types of uncemented stem were used, and American Society of Anesthesiologists （ASA） grading was significantly more severe for the fracture group （ P 〈 0. 05） . There were no significant differences between the 2 groups concerning the general data （ P 〉 0. 05） . Multivariate Logistic regression analyses revealed that age [ OR = 1. 268, 95% CI （1. 059, 1. 517）, P =0. 010] and type of uncemented stem [ OR =0. 072, 95% CI （0. 008, 0. 625）, P =0. 017] were independent risk factors for periprosthetic fracture. Conclusions The incidence of periprosthetic femoral fracture in the elderly pa- tients may be high following HA for femoral neck fractures. Since age and uncemented stem may be independent risk factors for periprosthetic femoral fracture, surgeons should pay enough attention to them in
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2017年第11期955-959,共5页
Chinese Journal of Orthopaedic Trauma
