Clinical Research of Intraoperative Femoral Fractures During Total Hip Arthroplasty Among Patients with High Dislocated Hip

Li Xiang; Ma Haiyang; Chen Yu'e; Liu Jiabang; Sun Jingyang

Abstract：Objective To analyze the frequency and risk factors of developing intraoperative periprosthetic femoral fractures in high dislocated hips treated by total hip arthroplasty(TH A).Methods We retrospectively collected data from 597 patients with high dislocation of the hip who underwent primary THA at the First Medical Center of PLA General Hospital between November 2005 and May 2019.There were 71 men and 526 women,aged 19 to 58 years,with an average age of(40.5±11.7)years.All patients were treated with a cementless modular femoral stem(S-ROM).Demographic variables included sex,age,height,weight,body mass index,diagnosis,history of previous femoral surgery,and presence of retained internal fixation devices.Surgical and technical variables included the size of each component of the S-ROM prosthesis(distal diameter,stem length,sleeve outer diameter,and sleeve bevel size),use of femoral shortening osteotomy,and prophylactic cerclage.Results Intraoperative femoral fractures occurred in 25 cases,with an incidence of 4.2％.Of these,9 were greater trochanteric fractures,5 were femoral neck fractures,and 11 were femoral shaft fractures.Univariate analysis showed that height,weight,and childhood hip infection sequelae were associated with the risk of intraoperative femoral fractures.The patients were followed up for 18 to 67 months,with an average follow-up of(20.82±9.30)months.2 cases had late femoral fractures,and 11 cases underwent revision surgery.Conclusion The incidence of intraoperative periprosthetic femoral fractures during THA for high dislocation of the hip is low.Height,weight,and childhood hip infection sequelae are factors for intraoperative femoral fractures.