Constantin Harry, Le Michael, de Steiger Richard, Harris Ian A
Liverpool Hospital, Sydney, New South Wales, Australia.
St George Hospital, Sydney, New South Wales, Australia.
ANZ J Surg. 2019 Dec;89(12):1647-1651. doi: 10.1111/ans.15519. Epub 2019 Oct 31.
Periprosthetic femur fractures (PFFs) following hip arthroplasty can lead to significant morbidity due to their impact on mobility and the need for surgery. Its incidence often measured by the prosthesis revision rate reported in joint replacement registries. However, many PFFs are also treated with prosthesis retention and internal fixation. Minimally displaced and stable fractures may be treated without surgery. Knowledge of the difference between the number of femoral revisions for PFF (well reported in registries) and the number of surgeries for PFF overall would allow us to estimate the overall surgical burden. This study aims to determine the number of post-operative PFF in three hospitals and compare those treated with revision surgery to those PFF treated with internal fixation and femoral stem retention. By determining this difference, we can ascertain a more accurate estimate of the overall surgical burden of PFF.
Patients 50 years and older who sustained a post-operative PFF between 1 January 2011 and 31 December 2017 at three public hospitals were extracted from hospital records. The number of revision procedures was compared to the number of re-operations of any type.
There were 200 patients admitted for management of PFF. One hundred and forty-three (71.5%) required an operation of which 67 (47%) were revision arthroplasty.
The overall surgical burden of PFF is approximately twice that represented by the revision rate.
髋关节置换术后股骨假体周围骨折（PFFs）会对患者活动能力产生影响且需要手术治疗，进而导致显著的发病率。其发病率通常通过关节置换登记处报告的假体翻修率来衡量。然而，许多PFFs也采用保留假体并进行内固定的治疗方法。轻度移位且稳定的骨折可能无需手术治疗。了解PFFs股骨翻修数量（登记处报告得较为详细）与PFFs总体手术数量之间的差异，将有助于我们估算总体手术负担。本研究旨在确定三家医院术后PFFs的数量，并比较接受翻修手术治疗的患者与接受内固定及保留股骨干治疗的PFFs患者。通过确定这种差异，我们可以更准确地估算PFFs的总体手术负担。
从医院记录中提取2011年1月1日至2017年12月31日期间在三家公立医院发生术后PFFs且年龄在50岁及以上的患者。将翻修手术的数量与任何类型的再次手术数量进行比较。
共有200例患者因PFFs入院治疗。其中143例（71.5%）需要进行手术，其中67例（47%）为关节置换翻修术。
PFFs的总体手术负担约为翻修率所代表负担的两倍。
