Analysis of risk factors for postoperative re-fracture of the hip in elderly patients
10.3760/cma.j.issn.0254-9026.2025.10.006
- VernacularTitle:老年髋部骨折术后再骨折的危险因素分析
- Author:
Di WU
1
;
Sen LIN
1
;
Shicong TAO
1
;
Jiaqing CAO
1
;
Hui SUN
1
;
Junjie GUAN
1
;
Dajun JIANG
1
;
Shizan HE
1
;
Huipeng SHI
1
Author Information
1. 国家骨科医学中心，上海交通大学医学院附属第六人民医院骨科，上海 200233
- Publication Type:Journal Article
- Keywords:
Hip fractures;
Surgical procedures, operative;
Risk factors;
Re-fracture
- From:
Chinese Journal of Geriatrics
2025;44(10):1357-1362
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the related risk factors contributing to re-fracture after hip surgery in elderly patients.Methods:This retrospective analysis was conducted on the clinical data of 2 415 elderly individuals who underwent surgical treatment for hip fractures and were discharged from Shanghai Sixth People's Hospital between January 2016 and December 2021.Patients were grouped into re-fracture and non-re-fracture cohorts based on whether a second fracture occurred within three years after surgery.Demographics, clinical data, and postoperative functional rehabilitation outcomes of the two groups were collected, and univariate and multivariate logistic regression analyses were applied to identify the independent risk factors for re-fractures after surgery.Results:A total of 2, 000 patients who completed follow-up were included in the final analysis, aged 60~91 years, with a mean age of (75.4±8.2) years.Among them, 855 were male(42.75%), and the postoperative re-fracture incidence was 28.25% (565/2 000). Univariate analysis indicated that advanced age, fracture type at first onset, lower Harris scores, insufficient rehabilitation training, osteoporosis, diabetes, cerebrovascular disorders, visual impairment, and syncope were all significantly associated with re-fracture (all P<0.05), while gender differences were not statistically significant ( P>0.05). Multivariate regression confirmed the following as independent risk factors: age ≥75 years, postoperative Harris score <80, non-standard rehabilitation training, combined osteoporosis, diabetes, cerebrovascular disease, visual impairment, and syncope ( OR、 RR>1). Conclusions:Elderly patients are prone to re-fracture after hip surgery, and its occurrence is closely related to advanced age, inadequate functional rehabilitation, osteoporosis, and multiple internal medical comorbidities.In clinical practice, attention should be paid to standardized postoperative rehabilitation, systematic anti-osteoporotic therapy, and active intervention of comorbidities to reduce the incidence of re-fracture and improve the long-term prognosis of patients.
