The Clinical Research Of Periprosthetic Femoral Fractures After Artificial Hip Replacement

Objective: To retrospectively analyze the risk factors of periprosthetic femoral fractures and the clinical effects of different treatment methods of different types of fractures.Methods: A total of 35 cases of periprosthetic femoral fractures were collected in the First Affiliated Hospital of Fujian Medical University treated with hip replacement or hip revision,Including 13 intraoperative cases and 22 postoperative cases,record the patient's age,gender,the type of prosthesis,the cause of injury and other clinical data.According to Vancouver classification,There were 3 cases of A2 type,5 cases of A3 type,2 cases of AL type,3 cases of AG type,9 cases of B1 type,7 cases of B2 type,4 cases of B3 type and 2 cases of type C.On different types were taken conservative,open reduction and internal fixation,hip revision surgery and other different treatment methods,Record the time of surgery and intraoperative blood loss,Observation of preoperative and postoperative hip function,And apply the statistical analysis and comparison,To observe the risk factors of periprosthetic femoral fractures and the effect of different ways of treatment.Results: The overall incidence of femoral fracture around the hospital was 2.82%(35/1242),of which more female patients than male patients,The use of non-cemented prosthesis fractures more than the use of cement prosthesis,In the hip revision surgery,the operation time and the amount of bleeding in the fracture were higher than that in the primary replacement.The difference between the two groups was statistically significant(P<0.05).Except for 1 case of pulmonary infection by the treatment of respiratory treatment was cured after discharge,1 cases were infected with internal fixation,and fracture healing was achieved after the second revision and bone grafting,The other cases were not found complications,the average follow-up time of 19.44 months,The last follow-up Harris score averaged 84.06 points,of which3 cases were excellent,25 cases were good,6 cases were generally and 1 case waspoor,which was significantly higher than that before the operation.The excellent and good rate was 80%(28/35).The results of t test showed that the difference was statistically significant(P<0.05).X-ray examination did not find prosthesis loosening,prosthesis sinking,in addition to 1 case is still followed,the other cases have achieved bone healing,no malformation healing.Conclusion: The incidence of periprosthetic femoral fractures is increasing,and it is more common in female patients.The occurrence of periprosthetic femoral fractures is associated with many factors.It is very important to treat the patients with different types of patients with Vancouver classification system,which can improve the stability of fracture and repair the bone defect.