加长柄假体翻修人工髋关节置换后假体柄周围骨折

The treatment of periprosthetic femoral fractures with lengthened stem prosthesis revision

目的探讨加长柄假体翻修人工髋关节置换后假体柄周围骨折的有效性和安全性。方法采用加长柄假体翻修术治疗21例Vancouver B型股骨假体周围骨折患者。观察手术时间、术中出血量、髋关节功能Harris评分、疼痛VAS评分和并发症发生情况。结果手术时间127~296 min,术中出血量428~1 240 ml。患者均获得随访,时间12~37个月。骨折均骨性愈合,无假体松动。下肢深静脉血栓1例,大腿外侧异位骨化1例。末次随访时,髋关节功能Harris评分为86分±6分,VAS评分为1.69分±0.59分。结论加长柄假体翻修术治疗Vancouver B型股骨假体周围骨折安全有效。

Objective To explore the clinical effectiveness and safety of the treatment of periprosthetic femoral fractures after artificial hip replacement with lengthened stem prosthesis revision.Methods Twenty-one patients of Vancouver type B periprosthetic femoral fractures were treated with non-cemented and lengthened stem prosthesis revision.The clinical outcome were assessed with surgical time,intraoperative blood loss,Harris score of hip function,pain VAS and complications.Results The operative time was from 127 min to 296 min.The intraoperative blood loss volume was 428~1 240 ml.All the patients received follow-up of 12~37 months.The fractures were all bony union,without prosthesis loosening.One patient suffered deep vein thrombosis and one patient suffered heterotopic ossification.At the final follow-up,the Harris score of hip function was 86±6 points,and VAS was 1.69±0.59 points.Conclusions Lengthened stem prosthesis revision provides good and safe outcomes in treating Vancouver type B periprosthetic femoral fractures.