初次髋关节置换术中股骨假体周围骨折的危险因素分析

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Abstract Objective To explore the risk factors，the injury mechanism and distribution characteristics of intraoperative periprosthetic femoral fractures during hip arthroplasty.Methods A retrospective study was carried out on 1 633 patients(1 633 hips) hip arthroplasty between January 2015 and December 2020.There were 688 men and 945 women，and the age of patients ranged from 26 to 96 with an average age of (64.2±13.1) years.We divided all patients into fracture group and nonfracture group based on whether they had experienced femoral fractures during hip replacement surgery，analyzed the incidence，the risk factors，the injury mechanism and the type of intraoperative periprosthetic femoral fractures.Risk factors were studied according to univariate analysis，then got rid of the confound factors according to binary logistic regression analysis.Results The incidence of intraoperative periprosthetic femoral fractures was 3.9%(63/1 633).Univariate analysis showed that there were statistically significant differences between the fracture group and the nonfracture group in patient age (＜60 years，≥60 years)，obesity(BMI≤28 kg／m²，＞28 kg／m²)，femoral medullary cavity morphology type，surgical approach，prosthesis type，and surgeon’s surgical volume(＜50 hips/year，≥50 hips /year) (P＜0.05).Multivariate logistic regression analysis showed that age，surgeon’s surgical volume，surgical approach，femoral morphology，and prosthesis type were risk factors for femoral periprosthetic fractures during initial hip replacement surgery.The femur fracture mainly occurred the Vancouver type A(65.1%，41/63 and intraoperative fractures mainly occured during the process of reaming and implant placement (92.1%，58/6-3).Conclusion The incidence of intraoperative periprosthetic femoral fractures was 3.9%，mainly occurring femoral trochanter. Periprosthetic fractures of the femur are closely related to age，surgeon’s surgical volume，the type of prosthesis，surgical approach and femoral morphology.

Key words： hip arthroplasty femoral periprosthetic fracture femoral morphology risk factor

Corresponding Authors: Zhang Yan

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	Tong Songming
	Liu Meng
	Zhou Yong
	Ouyang Xiao
	Zhang Yan

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Tong Songming,Liu Meng,Zhou Yong, et al. The Analysis of Risk Factors for Intraoperative Femoral Periprosthetic Fracture During the Primary Hip Arthroplasty[J]. sygkzz, 2023, 29(9): 787-.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2023/V29/I9/787

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