Post-surgery Risk Factors Of Contralateral Re-fracture Among The Elder Hip Fracture

Purpose Following the formation of global ageing society,disease generated from the decreased organism function has because a critical problem that doctors have to confront.Over the past few years,an ascending tendency of in-hospital rate and mortality is noted in the elder hip fracture patients in both china and world-wide.Together with the improvement of nursing,perfection of the modern clinical therapies,and more specified surgery procedures,a stable rise of promising life-time is anticipated,following an ageing society.Bin facing with such a condition of benign circulation,the elder suffering from a primary hip fracture surgery,may have to live with the fact of a high rate of re-fracture during the daily life or physical exercises.The purpose of the article is to give a clue of risk factors in the elder primary hip fracture that may cause a re-fracture of the contralateral side.Also,from the summary,we want to shed light on what is a reasonable medication,daily nursing,and specified physical exercises procedures.Then,we can avoid the re-fracture to the maximum.Methods The elder hip fracture patients with a total number of 361 were in-hospitalized and treated in PLA Army General Hospital during Nov 2011 to Dec 2013,which is a teach base of Shan Xi Medical University.And the data of these patients were retrospectively analyzed.Risk factors of contralateral hip re-fracture such as: numbers of patients,age,gender,type of fracture,methods of internal fixations,bone density,and medical complications were statistically analyzed,and to found out if there was a relationship between the risk factors and contralateral hip re-fracture.Results The total number of the patients in-hospitalized and treated in our hospital was 361,of which,21 patients suffered from a contralateral hip re-fracture,with a re-fracture rate of 5.82%.when the collected data was processed,it showed as follows: 1.age : 361 patients were classified into re-fracture group(21 patients)and non-fracture group(340 patients),according to if there was a fracture of the contralateral hip.A significance was noted between the two groups(P=0.032).2.gender: of the 21 re-fracture patients,9 were males and 12 were females,and there was no statistical significant between genders(P=0.750).3.type of initial fracture: inter-trochanter fracture saw in 11 patients,femur neck fracture saw in 10 patients,and the difference was statistically significant(p=0.041).4.Methods of the surgery: 129 of the 361 patients received hollow screw fixation,while the number of INTERTAN fixation,hip joint replacement,PFNA fixation,DHS fixation was 87,65,47,33,respectively.And contralateral hip re-fracture was saw in 8,5,3,3,2 respectively,a significance was noted(P=0.022).5.Medical complications: 361 patients were classified according to ASA gradation.ASA grade between grade Ⅰto grade Ⅱ was found in 117 patients,and 4patients were suffered from re-fracture.ASA grade higher than grade Ⅲwas found in 244 patients,who were accompanied with different level of medical complications,17 of whom had a re-fracture of the contralateral hip.The difference between the two groups was statistically significant.6.Bone density: pre-surgery bone density of the neck of femur was obtained in the 361 hip fracture patients.Osteoporosis was diagnosed when T≤-2.5 osteopenia was diagnosed when-2.5<T<-1.0,T ≥-1.0 was thought as normal,the number of each was 237,82,42,respectively.15 of the osteoporosis patients,4 of the osteopenia patients,and 2 of the normal bone density patients were suffered from contralateral hip re-fracture.A significance was noted among the three groups(P=0.031).Conclusions 1.Age is considered as a risk factor for the initial hip fracture patients in the elder;who may suffer from a contralateral hip re-fracture;2.There is no significant difference in the occurrence of contralateral hip re-fracture between the patients of different genders;3.Compared with the intertrochanteric fracture patients,patients with neck fracture of the femur shows a feature of younger in age,and more condense bone density.Intertrochanteric fracture patients usually accompanied with other traumatic fractures,which makes these patients more susceptible to contralateral hip re-fracture;4.Patients who have had percutaneous hollow screw internal fixation are more susceptible to contralateral hip fracture,when compared to those who have had artificial hip joint replacement or PFNA;5.Cerebrovascular disease,optic problems and various syncope are high risk factors in contralateral re-fracture of the elder with initial hip fracture;6.The occurrence of contralateral hip re-fracture in the osteoporosis patients is much higher than the ones who are osteopenia or with a normal bone density,according to pre-surgery bone density measurement of the neck of femur.