髋关节周围假体骨折后修复和固定的结果：回顾性服务评估

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-06-05 DOI:10.1016/j.jcot.2025.103080

Styliani Zachari , Amr H. Ahmed , Alexander Mott , Osama Tawfiq , Syed S. Ahmed

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引用次数: 0

摘要

本研究旨在报道翻修和ORIF治疗假体周围股骨近端骨折（ppff）的临床结果。材料,方法：我们在二级创伤中心进行了为期两年的回顾性分析，重点是手术治疗的原发性和改良全髋关节和半关节置换术后的ppff。主要观察结果为术后1年再手术率和术后死亡率。我们还专门分析了B2骨折的处理。次要结局是并发症发生率、手术时间、住院时间、输血量和重症监护要求。结果共纳入67例患者，其中女性44例（66%）。手术时平均年龄83岁。其中翻修27例（40%），ORIF 40例（60%）。术后1年再手术率为11.11%，术后1年再手术率为7.50%。改良手术的1年死亡率为25.93%，ORIF的1年死亡率为10%。翻修手术的总并发症发生率为29.63%，ORIF手术的总并发症发生率为7.50%。两组的手术时间（89和77小时）和住院时间（18和17天）相似。B2骨折48例（71.64%），翻修手术比例（27例）高于ORIF（21例）。对于B2骨折，与ORIF相比，翻修与更高的再手术率和死亡率以及更大的并发症发生率相关。结论ppff面临着巨大的医疗挑战。改善PPFF患者的临床结果至关重要。本研究强调，当解剖复位可行时，ORIF可能对B2骨折产生更好的结果。(249字)

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Outcomes of revisions and fixations following periprosthetic fractures around the hip: a retrospective service evaluation

Background

Our study aims to report clinical outcomes of revision and ORIF for managing periprosthetic proximal femur fractures (PPFFs).

Materials & methods

We conducted a two-year retrospective analysis at a level 2 trauma centre, focusing on surgically managed PPFFs from primary and revised total hip and hemiarthroplasties. Primary outcomes were the one-year reoperation rate and mortality rate following revision or ORIF. We also specifically analysed B2 fracture management. Secondary outcomes were complication rates, time to surgery, length of hospital stay, transfusions and critical care requirements.

Results

67 patients were included, 44 (66 %) of whom were female. Mean age at operation was 83 years. Among them, 27 (40 %) had revision and 40 (60 %) had ORIF. One year reoperation rate was 11.11 % for revision and 7.50 % for ORIF. One year mortality rate was 25.93 % for revision and 10 % for ORIF. The overall complication rate was 29.63 % for revision and 7.50 % for ORIF. Time to surgery (89 and 77 h) and length of hospital stay (18 and 17 days) were similar in both groups.B2 fractures, which constituted 48 (71.64 %) of the cases, had a higher proportion of revision surgeries (27) compared to ORIF (21). For B2 fractures, revision was associated with higher reoperation and mortality rates as well as a significantly greater complication rate compared to ORIF.

Conclusion

PPFFs present a substantial healthcare challenge. Improving clinical outcomes for PPFF patients is crucial. This study highlights that ORIF may yield better outcomes for B2 fractures, when anatomical reduction is feasible. (249 words)

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.