The distal femoral fracture is a common type of osteoporotic fractures of lower extremities in the elderly. Because this kind of patients are mostly characterized by osteoporosis, comminuted fracture and poor general condition, the clinical treatment faces challenges. With the deepening understanding of this type of fracture and development of internal fixation devices and surgical techniques, more new treatment methods have been gradually applied. The authors retrieve and summarize the latest research progresses in surgical approaches, internal fixation and anti-osteoporosis drug therapy in recent years, in order to provide references for clinical treatment of senile osteoporotic distal femur fracture.

Objective:To analyze the incidence rate and risk factors of hip fracture in older adult patients with stroke in Wenzhou, Zhejiang Province.Methods:A total of 4 500 older adult patients with stroke, aged ≥ 65 years, who received treatment at the Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine between January 2016 and January 2021 were included in this study. There were 2 245 males and 2 255 females. Patient case data were used as the primary data source and the incidence rate of hip fracture was calculated. Furthermore, risk factors for hip fracture in older adult patients with stroke were analyzed using univariate analysis and multivariate logistic regression analysis.Results:The incidence rate of hip fractures within 2 years of stroke was 6.58% (296/4 500) among all patients, with a high proportion of 82.77% (245/296) of hip fractures occurring on the paralyzed side. Independent risk factors for hip fractures in older adult patients with stroke included bone mineral density (T-score) ≤ -1, a decrease in body mass index > 5% within 3 months of stroke, visual impairment, a Berg Balance Scale score < 45 points, a lower extremity Fugl-Meyer Scale score < 20 points, Modified Ashworth Scale (MAS) grade ≥ II for limb spasticity, and Manual Muscle Testing (MMT) grades for hip extensor muscle groups and knee extensor muscle groups < 3 ( OR=6.765, 6.772, 4.726, 5.491, 4.582, 6.294, 3.763, 4.236, all P < 0.05). Conclusion:Factors such as decreased bone density, weight loss, visual impairment, decreased lower extremity balance and motor function, lower extremity muscle spasticity, and weakened muscle strength are risk factors for hip fractures in older adult patients with stroke. Targeted preventive measures should be developed accordingly.