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人工关节周围股骨骨折后的生存情况:影响预后的因素

Survivorship After Periprosthetic Femur Fracture: Factors Affecting Outcome.

作者信息

Drew Jacob M, Griffin William L, Odum Susan M, Van Doren Bryce, Weston Brock T, Stryker Louis S

机构信息

OrthoCarolina Hip and Knee Center, Charlotte, North Carolina; Department of Orthopaedics, Medical University of South Carolina, Charleston, South Carolina.

OrthoCarolina Hip and Knee Center, Charlotte, North Carolina.

出版信息

J Arthroplasty. 2016 Jun;31(6):1283-1288. doi: 10.1016/j.arth.2015.11.038. Epub 2015 Dec 9.

Abstract

BACKGROUND

Data addressing risk factors predictive of mortality and reoperation after periprosthetic femur fractures (PPFxs) are lacking. This study examined survivorship and risk ratios for mortality and reoperation after surgical treatment for PPFx and associated clinical risk factors.

METHODS

A retrospective review was performed for 291 patients treated surgically for PPFx between 2004 and 2013. Primary outcomes were death and reoperation.

RESULTS

Mortality at 1 year was 13%, whereas the rate of reoperation was 12%. Greater span of fixation and revision arthroplasty (vs open reduction internal fixation) trended toward a lower likelihood of reoperation.

CONCLUSION

After PPFx, patients have a 24% risk of either death or reoperation at 1 year. Factors contributing to increased mortality are nonmodifiable. Risk of reoperation is minimized with greater span of fixation and performance of revision arthroplasty.

摘要

背景

目前缺乏关于预测人工关节周围股骨骨折(PPFxs)后死亡率和再次手术的危险因素的数据。本研究调查了PPFx手术治疗后死亡率、再次手术的生存率和风险比以及相关临床危险因素。

方法

对2004年至2013年间接受PPFx手术治疗的291例患者进行回顾性研究。主要结局为死亡和再次手术。

结果

1年时死亡率为13%,而再次手术率为12%。固定范围更大和翻修关节成形术(与切开复位内固定相比)再次手术的可能性呈降低趋势。

结论

PPFx后,患者1年时死亡或再次手术的风险为24%。导致死亡率增加的因素是不可改变的。通过更大的固定范围和翻修关节成形术可将再次手术的风险降至最低。

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