Retrospective Study On The Reasons For Periprosthetic Fracture Of Collum Femoris Preserving Stem

Objective:To study the causes of periprosthetic fractures in the total hip replacement with collum femoris preserving stem,to prevent periprosthetic fracturesMethods:Through the electronic medical record system in the Third Hospital of Hebei Medical University,we retrieved the first biotype femoral neck total hip arthroplasty from January 2014 to December 2016 in the orthopaedics department of Hebei Medical University third hospital.A total of 513 patients were included in the study,of which 89 were using other prostheses,23 of them were incomplete or erroneous in medical record information or imaging information,29 of them underwent revision surgery or exclusion surgery,and then underwent hip replacement.The final 372 and 576 hips were included in the research into the inclusion criteria.There were 342 hip and 234 hips in male,and the sex ratio was 1.7/1.The general information of patients was collected,including age,sex,surgical side,body weight index(Body mass index),smoking and drinking volume,surgical indications,accompanying diseases,corticosteroid hormone history,history of operation of femoral head and operation experience.The preoperative imaging data of the patients were adjusted with the PACS system in our hospital.The use of Microsoft Office Excel 2003 medical records data entry and collation,using SPSS19.0 statistical software analysis,age,gender,surgical side,body mass index(Body mass index),smoking and alcohol consumption,surgical indications,with associated diseases,application of corticosteroid hormone history,previous surgery and postoperative femoral head have experience of periprosthetic,morphology of proximal femoral medullary cavity type and intraoperative fracture.Result:1.CFP periprosthetic fractures of the femur were not associated with age,sex,BMI,side,smoking,drinking,and bone density.2.There is a significant correlation between CFP periprosthetic fracture and preoperative diagnosis(necrosis of the femoral head / avascular necrosis of the femoral head),previous operation history,combined use of hormone and dosage3.There was no significant correlation between CFP periprosthetic fracture and K-L classification,Dorr typing,cortical index,neck angle,anterior dip,and pulposus width4.CFP femoral periprosthetic fracture has significant correlation with sagittal femoral neck / femoral shaft cross-sectional diameter index,coronal femoral neck / femoral shaft cross-sectional diameter index,osteotomy location,osteotomy angle,and proximal femur lesion5.Preoperative diagnosis of ankylosing spondylitis,previous operative history,hormone application,bone mineral density,osteoporosis and severe osteoporosis,coronal femoral neck / femoral shaft cross-sectional diameter index and osteotomy angle were risk factors for periprosthetic femoral fractures6.Ankylosing spondylitis,osteotomy location,operative experience and bone mineral density were severe osteoporosis and coronal femoral neck / femoral shaft diameter index.7.Proximal femoral disease,past operative history and coronal femoral neck / femoral shaft diameter index are independent risk factors for periprosthetic fractures during prosthesis implantation.8.Bone density for severe osteoporosis and hormone application are independent risk factors for periprosthetic fractures after prosthesis implantationConclusion:1.Periprosthetic fractures in CFP mainly occur in the process of reaming and prosthesis implantation2.Ankylosing spondylitis,past operative history,past proximal femoral disease,coronal femoral neck / femoral shaft cross-sectional diameter index and osteotomy position are independent risk factors for intraoperative periprosthetic fractures3.Compared to the Dorr type,the type of prediction of CFP is more important for periprosthetic fracture...