Department of Orthopaedics, Scott & White Healthcare, 2401 South 31st Street, Temple, TX 76508, USA.
J Bone Joint Surg Am. 2012 Mar 7;94(5):418-25. doi: 10.2106/JBJS.J.01134.
As the population ages, the number of proximal femoral fractures seen each year is expected to increase. Subsequent contralateral hip fractures have been reported to occur in as many as 11.8% of patients after surgical fixation of the initial fracture, but it is unknown if this rate is similar among patients managed with different surgical procedures.
A retrospective comparative study was performed at a single institution at which electronic medical records and digital radiographs were reviewed for 1177 patients who underwent closed reduction and percutaneous pinning or arthroplasty for the treatment of a proximal femoral fracture. For the primary outcome of subsequent fracture, logistic regression analysis was applied.
Four hundred and ninety-five patients were managed with closed reduction and percutaneous pinning, and 682 were managed with arthroplasty. Patients who underwent closed reduction and percutaneous pinning were two times more likely to have a subsequent contralateral femoral fracture in comparison with those who underwent arthroplasty, with contralateral fracture rates of 10.10% for the closed reduction and percutaneous pinning group and 5.57% for the arthroplasty group (p = 0.0035).
Patients undergoing closed reduction and percutaneous pinning as the initial treatment for a hip fracture had an increased risk of a subsequent contralateral hip fracture in comparison with those undergoing arthroplasty, after controlling for patient characteristics.
随着人口老龄化，每年发生的股骨近端骨折数量预计将增加。据报道，在初次骨折固定手术后，多达 11.8%的患者会发生对侧髋部骨折，但目前尚不清楚在接受不同手术治疗的患者中，这一比率是否相似。
在一家单机构进行了回顾性对比研究，对 1177 例接受闭合复位和经皮钉固定或关节置换术治疗股骨近端骨折的患者的电子病历和数字 X 线片进行了回顾。对于后续骨折这一主要结局，应用了逻辑回归分析。
495 例患者接受闭合复位和经皮钉固定治疗，682 例患者接受关节置换术治疗。与接受关节置换术的患者相比，接受闭合复位和经皮钉固定治疗的患者发生对侧股骨骨折的可能性高两倍，闭合复位和经皮钉固定组的对侧骨折发生率为 10.10%，关节置换组为 5.57%（p = 0.0035）。
在控制患者特征后，与接受关节置换术的患者相比，初次接受闭合复位和经皮钉固定治疗的髋部骨折患者发生对侧髋部骨折的风险增加。
