人工全髋关节置换术后假体周围骨折的若干问题

Some problems of periprosthetic fracture after total hip arthroplasty

全球人口老龄化趋势日益凸显,老年患者髋部疾病比例逐年递增,全髋关节置换术(THA)治疗老年髋部疾病疗效显著,手术技术及适应证得到广泛的普及,但与之对应的术中及术后股骨假体周围骨折(PFF)的发生也逐年增多。近30年内,PFF的发生率每10年以4.6%的速度在增长,占所有THA翻修手术的9.3%~14.7%,仅次于假体无菌性松动和感染。THA术后假体周围骨折的患者多为高龄伴有多种内科疾病,手术难度及风险较大,为了改善患者术后关节功能及术后生活质量,减少术后并发症及死亡率,国内外医生不断探索新的治疗方法,大多主张早期手术。根据骨折的类型采用相应的治疗方式,本文拟从假体周围骨折的预防及治疗中注意的细节问题进行阐述,以期提供更好的参考意见。

The aging trend of the global population is becoming increasingly prominent,the propor-tion of hip diseases in elderly patients is increasing year by year,total hip arthroplasty(THA)is effective in the treatment of elderly hip diseases,and surgical techniques and indications have been widely popularized,but the incidence of intraoperative and postoperativeperiprosthetic femoral fractures(PFF)is also increasing year by year.In the past 30 years,the incidence of PFF is increasing at a rate of 4.6%every 10 years.It ac-counts for 9.3%-14.7%of all THA revision operations,second only to aseptic loosening and infection of the prosthesis.Most of the patients with periprosthetic fractures after total hip arthroplasty are elderly patients with a variety of medical diseases,and the operation is difficult and risky.in order to improve the postopera-tive joint function and quality of life,and reduce postoperative complications and mortality,doctors at home and abroad continue to explore new treatment methods,most of them advocate early operation.According to the type of fracture to adopt the corresponding treatment,this paper intends to explain the details of the pre-vention and treatment of periprosthetic fracture,in order to provide better reference.