锁定加压钢板合并捆扎带治疗股骨假体周围骨折

Treatment of femur periprothetic fracture after hip arthroplasty with locking compressive plate and cable

目的探讨捆扎带合并锁定加压钢板固定治疗股骨假体周围骨折的临床效果。方法对7例股骨假体周围骨折进行切开复位，锁定加压钢板固定，在含有假体的股骨近折端用锁定螺钉作单侧骨皮质固定，不含假体的股骨远折端作双侧骨皮质螺钉固定，同时在包含假体的骨折端两侧利用捆扎带将股骨及钢板同时捆扎固定，自体骨或异体骨植骨。对假体不稳的患者在骨折复位后行假体翻修术。结果术后患者可早期起床运动：随访5个月～3年，骨折未见移位，7例假体周围骨折均获得愈合，髋关节功能得到恢复。假体未见松动。结论股骨假体周围骨折大多为长螺旋型骨折，捆扎带合并锁定加压钢板治疗股骨假体周围骨折简单有效，固定效果确切，根据骨缺损情况辅以植骨，可获得良好的临床效果。

Objective To investigate the clinical effect of locking compressive plate and cable fixation in management of periprosthetic femoral frature. Methods 7 cases of periprosthetic femoral fracture after total hip arthroplasty patients were treated with operation reduction and fixation with locking compressive plate combined with tiantium cable, with autograft or allograft. The cases with prothetic instability were treated with revision at the same time. Results The patients were pain free at the fracture site one week after the surgery, and was able to walk with a cane 3 months after the surgery. All patients were followed up for five months to three years with average of lO months. Bony healing was obtained in all the patients. Harris score did not change significantly and the patients recovered full function without pain. Therening was no loosening signs around the stem. Conclusions Most of the femur periprothetic fractures are long spiral frature, locking compressive plate and cable fixation is an simple, effective method for periprosthetic femoral frature. With bone graft in bone loss patient, it can obtain good clinic effect.