Analysis and prevention of the risk factors of recurrent fracture in elderly patients with hip replacement

WANG Hai-bin; SHI Fa-jian

doi:10.3969/j.issn.1009-4237.2016.09.006

Abstract：Objective To explore the risk factors and prevention of recurrent fracture in elderly patients after hip replacement surgery. Methods Totally 180 elderly patients with hip replacement in our hospital from Jan.2008 to Jan.2011 were followed up,including 24 patients who had recurrent hip fracture within 3 years.The indexes including gender,age,living environment( rural/urban) ,postoperative BMD value of the healthy contralateral hip,healthy femoral proximal trabecular type( Singh index) ,total length of hospital stay,days for lying in bed,com-bined diseases and osteoporosis treatment were compared between the fracture and non-fracture group,so as to ex-plore the risk factors for recurrent fractures.Results Age and gender of the two groups had no statistically signifi-cant difference(P<0.05),but the proportion of fracture patients from rural areas was significantly higher than that of the non-fracture group,and the differences were statistically significant(P<0.05).The average hospitalization time and the days for lying in bed after discharge in the fracture group were significantly longer than those of the non-fracture group,and the differences were statistically significant(P<0.05).The proportion of healthy side Singh in-dex lower than gradeⅢin the fracture group and the proportion of non-regular anti-osteoporosis treatment were sig-nificantly higher than those in the non-fracture group,and the differences were statistically significant (P<0.05). Through the single factor logistic regression analysis,rural area,long duration of hospitalization,long time for lying in bed after discharge,low bone density,low Singh index,non-regular anti-osteoporosis treatment and the presence of com-bined chronic medical diseases were the risk factors of recurrent fractures in the contralateral hip.Conclusion In elderly patients with hip arthroplasty,low hip bone density value,Singh index lower than gradeⅢ,long time for lying in bed,combined chronic medical diseases and poor anti-osteoporosis therapy are risk factors for contralateral recur-rent fracture.Therefore,we should initially actively treat the complicated medical diseases,take anti-osteoporosis therapy and early functional training so as to avoid the recurrent fractures of contralateral hip.