非典型股骨假体周围骨折的诊疗进展

Advances in diagnosis and treatment of atypical periprosthetic femoral fractures

非典型股骨假体周围骨折(atypical periprosthetic femoral fracture,APFF)是一组特殊的股骨假体周围骨折,具有与非典型股骨骨折相似的临床病史和影像学特征。相较于普通的股骨假体周围骨折,APFF的诊断和治疗更具挑战性,容易出现骨延迟愈合、骨不愈合、内固定失败等严重并发症。然而,目前关于APFF的研究较少,其流行病学、发病机制、诊断标准和治疗策略尚不明确,缺乏对APFF规范化临床管理的建议和指导。本文回顾最新APFF文献报道并结合笔者自身临床工作经验,对APFF的诊疗进展进行阐述,以供广大骨科医师参考。

Atypical periprosthetic femoral fracture(APFF),as a special kind of periprosthetic femoral fractures,presents similar clinical history and radiographic features with atypical femoral fractures.Compared with ordinary periprosthetic femoral fractures,the diagnosis and treatment of APFF is more challenging since APFF is more prone to severe complications of delayed healing,nonunion,fixation failure,etc.However,few studies have focused on APFF and its epidemiology,pathogenesis,diagnostic criteria as well as treatment strategies.There is still lack of guidelines for the standard clinical management of APFFs.In this paper,we reviewed the latest advances in diagnosis and treatment of APFFs based on the published studies and our clinical experience.