Is Femoral Fracture Healing Really Compromised in Patients with Rheumatoid Arthritis? Comparison Study Between Rheumatoid and Non-rheumatoid Arthritis Patientsopen access
- Authors
- Lee, Jin Kyu; Lee, Bong Gun; Jo, Young Hoon; Hur, Jeong Min; Kook, In Cheol; Hwang, Kyu Tae
- Issue Date
- Apr-2020
- Publisher
- WOLTERS KLUWER MEDKNOW PUBLICATIONS
- Keywords
- Femur fracture; Atypical femoral fracture; Rheumatoid arthritis; Delayed union; Nonunion
- Citation
- INDIAN JOURNAL OF ORTHOPAEDICS, v.54, no.5, pp.599 - 607
- Indexed
- SCIE
SCOPUS
- Journal Title
- INDIAN JOURNAL OF ORTHOPAEDICS
- Volume
- 54
- Number
- 5
- Start Page
- 599
- End Page
- 607
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/142605
- DOI
- 10.1007/s43465-020-00117-3
- ISSN
- 0019-5413
- 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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