形状记忆锯齿臂环抱内固定器在髋关节置换术后股骨假体周围骨折的临床应用

目的探讨形状记忆锯齿臂环抱内固定器在髋关节置换术后股骨假体周围骨折治疗中的应用疗效方法髋关节人工假体置换(THA)术后发生股骨假体周围骨折的患者9例,均采用形状记忆钛合金环抱器治疗,必要时辅以钢缆固定:术后定期随访,X线检查评估假体位置、骨折愈合情况及相关并发症的发生情况,采用Hams髋关节评分和數字评价量表(NRS)评估临床疗效。结果9例患者均获随访,随访时间3~55个月,平均28个月,术后切口均获一期愈合,无切口感染等并发症..骨折骨性愈合时间为2.5~5.5个月,平均4.2个月,术前髋关节Hams评分(23.4±10.2)分,术后6月髋关节Harris评分(89.6±9.30)分,髋关节功能较术前均得到明显改善(P<0.05),,所有患者均无假体松动、感染、内固定断裂、骨折不愈合等不良事件发生。结论采用形状记忆锯齿臂环抱内固定器治疗髋关节置换术后假体周围骨折具有骨折愈合率高、并发症少、功能恢复佳等优势,且临床疗效确切值得推广应用。

Objective To investigate the clinical application and efficacy of shape-memory sawtooth-arm embracing fixator in the management of periprosthetic femoral fracture after total hip arthroplasty.Methods From May 2014 to June 2019,a retrospective analysis was made on 9 patients with periprosthetic femoral fracture following total hip arthroplasty treated with shape-memory sawtooth-arm embracing fixator in our hospital,including 1 male and 8 females.According to the classification of Vancouver,there are type B1 in 4 cases,B2 type in 2 cases,B3 type in 1 case,and type C in 2 cases.Preoperative Harris score was performed,and during the follow-up,X-ray was used to evaluate the incidence of complications related to the surgery,such as fracture healing,internal fixator position,loosening and dislocation.At the final follow-up,Harris hip score for clinical evaluation.Results All patients were followed up for 3〜55 months,with an average of 28 months.The fracture healing time was 2.5 to 5.5 months,with an average of 4.2 months.The preoperative Harris score was(23.4±10.2),and the postoperative Harris score was(89.6±9.30).Compared with the preoperative,the hip joint flinction was significandy improved(P<0.05).All patients had no adverse events such as prosthesis loosening,infection,fracture of internal fixation,fracture nonunion.Conclusion The periprosthetic femoral fracture following total hip arthroplasty treated with shape-memory sawtooth-arm embracing fixator have the advantages of high fracture healing rate,decreasing the complications and better functional recovery,which is worth promoting the application.