The Study Of Correlation Analysis Between Periprosthetic Femoral Fractures And Proximal Femoral Medullary Cavity Form

ObjectiveTotal Hip Arthroplasty (THA hereunder) includes Periprosthetic fractures that occurs during the surgery and that occurs after the surgery; the author is to discuss the pathogenesis, reason and type of it; to analyse the relevancy between THA and the morbidity of Periprosthetic Femoral Fractures (PFF hereunder); to compare the Proximal bone marrow cavity of THA patient with all kinds of prosthesis. With the study on Proximal bone marrow cavity of THA and PFF, the author try to make sure the risks and strengthen safety measures, so that the safety of THA can be improved, and the rate of complication can be decreased.MethodsThis study mainly enployed retrospective Clinical trials research methods, and also made use of the information of all kinds of THA patients who Accepted THA during Jan.2011to Nov.2013of the first and the second affiliated hospitals of Guangzhou University of Chinese Medicine. By classifying to medullary cavity of THA patients, choosing prosthesis during the surgery, doting statistics on PFF, while X2-Test was applied to enumeration data, Independent-Samples T Test was applied to measurement data, SPSS19.0statistical software was applied to number data, and with the standard that the study is statistical significant in the case of P<0.05, and is obviously statistical significant in the case of P<0.01, the author estimated the differences between the rate of PFF of patients with different marrow cavity, thus made an deeper discussion on the distribution of marrow cavity of THA, the choice on prosthesis and the ways to decrease the rate of PFF.ResultsIn this study,1156THA patients of over-40was treated, including708 females and448males, aging from40to93, with an average age of69.62±6.07.638patients aged from60to79, which made the highest percentage of55%. According the1156pre-surgery hip arthroplasty X-ray film, most marrow cavity are normal (926)---80.10%,132are of champagne---11.4%, and98are of stovepipe---8.48%. Among the448males,65are of champagne---14.52%,357are normal---79.69%, and26are of stovepipe---5.8%. Among the708females,67are of champagne---9.5%,569are normal---80.73%, and72are of stovepipe---10.17%.During all the surgeries, PFF occurred to33patients, including10males and23females, which made the rate of2.85%. Among the10males,7aged from60to79, and3aged over80, with an average age of74±7.8; among the23females,2aged from40to59,17aged from60to79, and4aged over80, with an average age of69.5±3.1. From the angle of marrow cavity morphology, the33that PFF occurred to during surgery included11of champagne (4males and7females),7of stovepipe (1male and6females) and15normal ones (5males and10females). Overall, among the samples, the rates of PFF to patients that with marrow cavity of champagne, stovepipe and normal type are8.33%,7.14%and1.62%.ConclusionThe reasons that may cause PFF varied. From the angle of the situation of the distribution of femoral myelocavity, the rates of PFF in the cases of champagne and stovepipe are obviously higher than that in normal cases, and the main reason is abnormal distribution of femoral myelocavity and poor matching of prosthesis. Meanwhile, PFF occurred far more to females than to males, and the main reason is the rarefaction of bone of females after menopause. To avoid PFF, except accurate measurement before surgery, good preoperative plan, suitable prosthesis choosing have to be done, improving the technical merit of operators and reinforcing nursing of perioperative period are also necessary. Doctors should handle the risks of PFF, treat with multidisciplinary techniques to decrease the risks of surgery, and inform his patients the pros and cons of the operation and the risk of PFF, so that the quality of medical care can be improved.