全髋关节置换假体柄周围骨折的治疗

Treatment of periprosthetic fracture of the femur in total hip arthroplasty

目的 :回顾性研究全髋关节置换假体柄周围骨折的治疗及预防。方法 :将本院近年收治的全髋置换假体柄周围骨折的 8例病例按Vancouver分类方法进行分类 ,其中A1型 3例 ,B1型 3例 ,B2型 1例 ,B3型 1例 ,分别用钢丝环扎固定 ,异体皮质骨板加钢丝环扎 ;骨水泥长柄假体翻修。结果 :术后随访 8～ 18个月 ,骨折愈合 ,假体固定可靠。结论 :全髋关节置换术后假体柄周围骨折用Vancouver分类方法分类 ,简单、适用。采用异体皮质骨板与钢丝环扎固定骨折 ,治疗假体柄周围骨折 ,不仅固定可靠而且能促进骨折愈合、恢复骨量。

Objective: To study the treatment and prevent periprosthetic fractures of femur in total hip arthroplasty retrospectively.Methods: According to the classification of Vancouver, 8 cases of periprosthetic fractures of the femur in total hip arthroplasty in recent years were analyzed. There were three cases of type A1, three cases of type B1, one case of type B2, one case of type B3. Open reduction and fixation with wires and allograft cortical strut bone or a long-stem cemented prosthesis revision were performed respectively. Results: Through eight to eighteen months follow-up, all the fractures were united, and incoorperation occured between the strut bone and host bone. The prosthesis stem fixed well. Conclusion: Vancouver classification in the periprosthetic fracture of the femur after total hip arthroplasty is a simple and practical method. Onlay allograft cortical strut bone and fixed with wires for the treatment of periprosthetic fracture of the femur is a practical method, this method can not only promote the fracture union but also restore the bone stock.