Niculescu Victor, Dimitriu Alexandru Lisias, Nistor-Cseppento Delia Carmen, Tirla Sebastian, Gherle Anamaria, Uivaraseanu Bogdan, Burnei Cristian
University Doctoral School, "Carol Davila" University of Medicine and Pharmacy, 050074 Bucharest, Romania.
Department 14 Orthopedics-Intensive Care, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Clin Pract. 2025 Jun 12;15(6):110. doi: 10.3390/clinpract15060110.
Periprosthetic fractures (PFs) can occur in both the upper and lower limbs, commonly resulting from falls at the same level. The frequency of PFs following total hip arthroplasty (THA) ranges from 0.045% to 4.1%, and this incidence is influenced by several factors, including age, gender, the type of prosthesis used, and existing comorbidities. Previous studies on this subject have been small in scale and did not adequately address the associated comorbidities, which pose a challenge for the aging population. This study aims to comparatively assess the incidence of THA-related PFs, immediate postoperative complications, and comorbidities in patients with PFs from three emergency hospitals. A retrospective observational study was conducted from 1 January to 31 December 2024, in which 54 patients with PFs hospitalized in three emergency hospitals (Bucharest, Oradea, and Ploiești) were evaluated, divided into Group B ( = 29), Group O ( = 14), and Group P ( = 11). Of all patients with PFs, 81.48% had minor complications-grade 1, 9.26% had grade 2 complications (complications requiring medical treatment or other minor interventions), and 3.70% had complications requiring surgery or invasive procedures. Clavien-Dindo grade 5 (patient death) had an incidence of 3.70%. Cardiac pathology was the most common pathology; hypertension predominated in Group O (42.85%). Alzheimer's disease was associated in 7 patients (12.96%). Without associated pathology, about 13% of patients were identified. Diabetes mellitus also occurred frequently in 31.50%. Data analysis indicates a very weak positive correlation between the Dindo Index and the Charlson Comorbidity Index (r = 0.046), which is not statistically significant ( = 0.628). The effect size, measured by Fisher's z, is also reported as 0.046. No significant differences were found among the evaluated centers regarding therapeutic approaches, postoperative complications, and associated comorbidities. Furthermore, there is insufficient evidence to suggest a significant association between the Charlson Comorbidity Index and the Clavien-Dindo Index.
假体周围骨折（PFs）可发生于上肢和下肢，通常由同一水平的跌倒所致。全髋关节置换术（THA）后PFs的发生率在0.045%至4.1%之间，这一发生率受多种因素影响，包括年龄、性别、所用假体类型以及现有合并症。此前关于该主题的研究规模较小，且未充分解决相关合并症问题，而这对老年人群构成了挑战。本研究旨在比较评估来自三家急诊医院的PFs患者中THA相关PFs的发生率、术后即刻并发症及合并症情况。于2024年1月1日至12月31日进行了一项回顾性观察研究，对在三家急诊医院（布加勒斯特、奥拉迪亚和普洛耶什蒂）住院的54例PFs患者进行了评估，分为B组（n = 29）、O组（n = 14）和P组（n = 11）。在所有PFs患者中，81.48%有1级轻微并发症，9.26%有2级并发症（需要药物治疗或其他轻微干预的并发症），3.70%有需要手术或侵入性操作的并发症。Clavien-Dindo 5级（患者死亡）的发生率为3.70%。心脏疾病是最常见的疾病；O组中高血压占主导（42.85%）。7例患者（12.96%）伴有阿尔茨海默病。在无相关疾病的情况下，约13%的患者被确认。糖尿病在31.50%的患者中也频繁出现。数据分析表明Dindo指数与Charlson合并症指数之间存在非常弱的正相关（r = 0.046），无统计学意义（P = 0.628）。以Fisher's z衡量的效应大小也报告为0.046。在评估中心之间，关于治疗方法、术后并发症及相关合并症未发现显著差异。此外，没有足够的证据表明Charlson合并症指数与Clavien-Dindo指数之间存在显著关联。
