人工关节置换并发假体周围骨折的治疗

Management of periprosthetic fractures following artificial joint replacement

目的:探讨人工关节置换术中及术后假体周围骨折的治疗方法。方法:分析16例人工关节置换术并发假体周围骨折患者的临床资料。全膝关节置换术后假体周围骨折2例,1例行LISS钢板固定,1例行围关节钢板固定。术中股骨干骨折3例中,2例行捆绑带及钢丝固定,1例行钢板及捆绑带固定。其余11例股骨头置换术后假体周围骨折患者,按Vancouver假体周围骨折分型标准,2例(A型)1例采用牵引行保守治疗,1例行大转子骨折切复张力带固定治疗,5例(B型)应用加长柄全髋关节翻修术及钢缆捆扎治疗,4例(C型)应用解剖钢板内固定。结果:16例患者均得到随访,平均22月(6个月至4年),11例患者骨折均愈合,无感染及内固定断裂发生。关节置换组患者无假体松动、下沉及断裂等并发症发生。所有患者日常能生活能自理,效果满意。结论:人工关节置换术并发假体周围骨折的治疗比较困难,应根据患者的骨折部位,骨质质量及身体状况,采取积极有效的治疗措施。最终减少骨折的并发症,提高患者的生活质量。

Objective:To study the method for the treatment of periprosthetic fractures during operation and after joint replacement.Methods:From June 2001 to January 2005,16 cases(7men and 9 women) with periprosthetic fractures were treated in our department.The average age at the time of operation was 61 years(ranging from 55 to 74 years).13 cases suffered from slipping and the other three from operative injury(fractures of shaft of femur caused by revision of total hip prosthesis).of the 2 cases who underwent total ...