Lee JK, Lee BG, Jo YH, Hur JM, Kook IC, Hwang KT. Is Femoral Fracture Healing Really Compromised in Patients with Rheumatoid Arthritis? Comparison Study Between Rheumatoid and Non-rheumatoid Arthritis Patients.
Indian J Orthop 2020;
54:599-607. [PMID:
32850023 PMCID:
PMC7429632 DOI:
10.1007/s43465-020-00117-3]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 04/10/2020] [Indexed: 02/04/2023]
Abstract
BACKGROUND
In patients with rheumatoid arthritis (RA), some problems might occur in fracture healing; however, clinical evidence is limited. Therefore, we compared the time to union and complication rate of femoral fractures between RA and non-RA patients.
MATERIALS AND METHODS
This study included 42 RA patients who underwent osteosynthesis for femoral trochanter or shaft fracture. For comparison with the RA group, 126 non-RA patients were selected as a control group. The RA group was divided into the trochanteric (RA group I) and shaft fracture group (RA group II) for comparison with each control group (control groups I and II). We analyzed risk factors for nonunion or delayed union and divided patients according to whether atypical or ordinary fracture in shaft fracture.
RESULTS
Time to union (p = 0.823) and complication rate (p = 0.440) did not differ significantly between RA group I and control group I. A significantly longer time to union (p = 0.001) and higher nonunion rate (p = 0.013) were observed in RA group II compared with control group II. The presence of RA (p = 0.040) and atypical femoral fracture (p = 0.006) were significant risk factors for nonunion or delayed union.
CONCLUSIONS
The high prevalence of atypical femoral fracture among the femur shaft fractures in the RA patients was considered a significant risk factor for nonunion and delayed union.
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