Is Femoral Fracture Healing Really Compromised in Patients with Rheumatoid Arthritis? Comparison Study Between Rheumatoid and Non-rheumatoid Arthritis Patients

Jin Kyu Lee, Bong Gun Lee, Young Hoon Jo, Jeong Min Hur, In Cheol Kook, Kyu Tae Hwang

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)599-607
Number of pages9
JournalIndian Journal of Orthopaedics
Volume54
Issue number5
DOIs
StatePublished - 2020 Sep 1

Keywords

  • Atypical femoral fracture
  • Delayed union
  • Femur fracture
  • Nonunion
  • Rheumatoid arthritis

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