Trentini Conrado Auer, Balsano Marcela de Andrade, Deeke Mark, Zaniolo Francisco José
Serviço de Ortopedia e Traumatologia, Hospital Universitário Regional dos Campos Gerais, Ponta Grossa, PR, Brasil.
Serviço de Ortopedia e Traumatologia, Hospital Universitário Cajuru, Curitiba, PR, Brasil.
Rev Bras Ortop (Sao Paulo). 2024 Jan 31;59(5):e745-e751. doi: 10.1055/s-0044-1779320. eCollection 2024 Oct.
To determine the incidence of periprosthetic femoral fractures during the operation in primary hip arthroplasties and correlate them with the inherent risk factors associated with patients, implants, and the diagnosis of coxarthrosis and/or femoral neck fractures. Cross-sectional study, with retrospective analysis of medical records and image exams of patients operated between 2014 and 2019. The variables analyzed followed those proposed by the world literature, namely: age, sex, Dorr index, surgical indication, Vancouver classification, location, type of fixation (cemented or non-cemented), implant model used, intraoperative diagnosis, and corresponding treatment approach. All surgeries used the same posterolateral access route and were performed by the same group of surgeons. Within the sample of 2,217 arthroplasties (2,154 patients), 12 fractures (0.56%) were identified in 12 patients. The sample consisted of 8 females and 4 males, with an average age of 62.53 years. In all diagnosed cases, protective cerclages were added at the level of the lesser trochanter and/or the greater trochanter, and, in 3 cases, there was a change from uncemented to cemented femoral stems and only 1 required revision. Data Analysis Allows Us To State That The Risk Of Intraoperative Periprosthetic Fracture Is Greater In Women And With The Use Of Cementless Stems. The Occurrence Of These In This Study Had A Rate Of Less Than 1%.
确定初次髋关节置换手术中假体周围股骨骨折的发生率,并将其与患者、植入物以及髋关节病和/或股骨颈骨折诊断相关的固有风险因素相关联。横断面研究,对2014年至2019年接受手术患者的病历和影像检查进行回顾性分析。分析的变量遵循世界文献提出的变量,即:年龄、性别、Dorr指数、手术指征、温哥华分类、位置、固定类型(骨水泥型或非骨水泥型)、使用的植入物型号、术中诊断以及相应的治疗方法。所有手术均采用相同的后外侧入路,由同一组外科医生进行。在2217例关节置换术样本(2154例患者)中,12例患者中发现12处骨折(0.56%)。样本包括8名女性和4名男性,平均年龄62.53岁。在所有确诊病例中,在小转子和/或大转子水平添加了保护性环扎,3例患者从非骨水泥型股骨柄改为骨水泥型股骨柄,只有1例需要翻修。数据分析使我们能够指出,女性和使用非骨水泥型股骨柄时术中假体周围骨折的风险更高。本研究中这些骨折的发生率低于1%。