The Predictive Factors of Fracture in Patients with Fibrous Dysplasia of Proximal Femur

Objective To explore the influencing factors of fracture in patients with fibrous dysplasia (FD) of proximal femur. Methods Retrospective clinical observational study. A total of 49 patients with fibrous dysplasia of proximal femur who were examined and diagnosed at Department of orthopaedics of the 960th Hospital of the PLA Joint Logistics Support Force between January 2016 and January 2021 were included in the study. Among these patients, 27 were male and 22 were female. The average age was 30.8 years. There were 19 cases of monostatic fibrous dysplasia(MFD), as well as 35 cases of polystatic fibrous dysplasia(PFD) and McCune-Albright syndrome. All patients were examined by body mass index(BMI), bilateral hip X-ray film, femoral neck shaft angle measurement and bone metabolism, including N-terminal propeptide of type 1 procollagen (PINP), type 1 collagen carboxyl terminal peptide(β-CTx) and osteocalcin(OST). We divided the clinical and anatomical classification of all patients, and they were divided into fracture group and non fracture group according to whether they were fractured or not. Clinical data and imaging characteristics were analyzed retrospectively. Results In univariate analysis, there were statistically significant in clinical classification, anatomical classification, femoral neck shaft angle and osteocalcin (P༜0.01). In multivariate logistic analysis, there were statistically significant in anatomical classification, femoral neck shaft angle and osteocalcin (P༜0.05). Conclusions Anatomical classification, femoral neck shaft angle and osteocalcin are the important predictive factors of fracture in patients with fibrous dysplasia of proximal femur. We may effectively predict and prevent the fracture of patients with fibrous dysplasia of proximal femur through the examination of anatomical classification, femoral neck shaft angle and osteocalcin. In order to improve the accuracy and robustness of the conclusions and provide better clinical guidance, we need to conduct more comprehensive research in the subsequent clinical work.