两种手术方法治疗B1型股骨假体周围骨折的初步分析  

Comparison of Two Treatment Methods for Vancouver B1 Periprosthetic Femoral Fractures

作　　者：谢飞彬[1] 马军[1] 陈辉东[1] 林振宗[1] 崔岩[1] 杨镔[1] 叶桂峰[1] 王耀宗[1] 

机构地区：[1]厦门大学附属中山医院创伤骨科,福建厦门361004

出　　处：《武汉大学学报（医学版）》2013年第3期399-402,432,共5页Medical Journal of Wuhan University

摘　　要：目的:评估记忆合金环抱器和锁定加压接骨板及缆绳环扎固定治疗髋关节置换术后B1型(Vancouver分型)股骨假体周围骨折的疗效。方法:对2007年5月-2010年6月我院治疗的12例全髋关节置换术后B1型股骨假体周围骨折进行回顾性研究,其中5例采用记忆合金环抱器,7例采用锁定加压接骨板及缆绳环扎,记录每例患者的手术时间、术中出血量、骨折愈合时间、髋关节功能评分及费用等相关数据。结果:术后随访6-26个月,平均17.5个月。两组在手术时间、术中出血量无显著差异,髋关节功能(Harris评分)评分、骨折愈合时间有显著差异(P<0.05),接骨板+缆绳组虽然费用高于环抱器,但可实现较早骨折愈合。结论:Vancouver分型B1型股骨假体周围骨折的治疗重点是坚强固定髓腔内含有假体的股骨近端,两种方法随访期内均无骨不连、再骨折及内固定失效等并发症;短期随访结果显示,对于B1型股骨假体周围骨折治疗,随着经济发展及治疗观念的改变,锁定加压接骨板结合缆绳固定优势明显。Objective： To investigate the clinical effect of shape-memory embracing fixator or locking compression plate（LCP） and cable on the treatment of vancouver B1 periprosthetic femoral fractures（PPF）. Methods： Retrospective analysis of two groups of patients treated with either shape-memory embracing fixator（5 cases） or locking compression plate and cable（7 cases） was performed.The operation time, bleeding,Harris score,healing time and expenses were recorded and statistically compared.Results： The post-operative follow-up lasted 6-26 months.There were no differences between the two groups in operation time and bleeding,but statistical differences were found in Harris score and healing time.Although the LCP and cable is more expensive than embracing fixator,patients in LCP and cable group got earlier bone healing.Conclusion： The most important procedure of treatment for B1 PPF is rigid fixation of proximal femur,which contains prosthesis,and the LCP and cable method is preferred.

关 键 词：环抱器 锁定加压接骨板 股骨骨折 

分 类 号：R687.4[医药卫生—骨科学]