人工髋关节置换术中股骨假体周围骨折的危险因素分析

Analysis of risk factors for intraoperative periprosthetic femur fracture during hip arthroplasty

目的探讨行人工髋关节置换术患者术中股骨假体周围骨折的影响因素。方法回顾性分析我院2010年1月至2015年1月行人工髋关节置换术患者的资料,分析术中发生股骨假体周围骨折患者的性别、年龄、诊断、手术侧别、假体固定类型、假体形态、假体周围骨折类型等信息,分析骨折发生的可能相关因素。结果共随访430例,男170例,女260例,平均年龄71岁,其中有44例术中发生股骨假体周围骨折;根据Vancouver分型,A型41例,B型2例,C型1例。女性患者术中骨折发生率为15%,明显高于男性患者。右侧手术、应用生物型股骨假体者为股骨假体周围骨折发生的危险因素。结论对于女性、右侧手术、应用生物型股骨假体等因素的患者行人工髋关节置换术时需仔细,尽量避免股骨假体周围骨折的发生。

Objective To evaluate the risk factors for intraoperative periprosthetic femur fracture during hip arthroplasty and to explore strategies that would decrease incidence of this complication. Methods This study was consisted of430 patients who underwent hip arthroplasty from January 2010 to January 2015, including cases of primary total hip replacement（both cemented and uncemented） and hemiarthroplasties. Risk factors included gender, age, operating side and diagnosis. Results We followed 430 patients, 44 cases were diagnosed as intraoperative periprosthetic femur fracture. According to vancouver clasification, 41 cases were in type A, 2 cases were in type B, one case was in type C. We found female patient had a higher rate of intraoperative fracture than male patients with a 15% rate. And we found right side, uncemented implant were also risk factors. Conclusion Surgeons should be cautious when performing the operation of hip arthroplasty when the risk factors exist, including female, right side, uncemented implant present.