全髋关节置换后的股骨假体周围骨折  

Periprosthetic femoral fractures after total hip arthroplasty

作　　者：苗绍刚 鲁宁[1] 杨阳[1] 陈磊杰[1] Bassam A.Masri 

机构地区：[1]昆明医科大学第二附属医院骨科,云南省昆明市650101 [2]Department of Orthopaedics,University of British Columbia

出　　处：《中国组织工程研究》2014年第4期645-650,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:随着全髋关节置换及翻修患者的不断增加,股骨假体周围骨折的发生率及复杂性随之增加。目的:回顾有关股骨假体周围骨折的研究文献,探讨其危险因素、预防措施、Vancouver分型和治疗方案。方法:以电子检索方式对CNKI数据库、FMJS数据库及PubMed数据库1994年9月至2012年6月收录的有关全髋关节置换后股骨假体周围骨折的研究文献进行分析,检索词为"全髋关节置换,股骨假体周围骨折"和"total hip arthroplasty,periprosthetic femoral fractures",排除报道时间较早的研究或重复研究。结果与结论:随着全髋关节置换人数的增加,置换后股骨假体周围骨折发生率正在增加。目前公认的危险因素包括年龄、性别、创伤、固定方式、假体松动、翻修、骨溶解、置换前疾病、骨质疏松、假体类型和置换技术等。熟悉及理解股骨假体周围骨折的危险因素对其预防及治疗至关重要。Vancouver分型涉及股骨假体周围骨折位置及稳定性、假体松动情况、股骨近端骨量等,是临床上常用的分型方法。临床治疗应根据骨折类型、是否有假体松及骨缺损等采用不同的方法。BACKGROUND： As the patients undergoing total hip replacements and revision increase, the incidence and complexity of postoperative periprosthetic femoral fractures are accordingly increasing and its treatment becomes a challenge. OBJECTIVE： To review the literatures related to periprosthetic femoral fractures after total hip arthroplasty, to explore related risk factors, Vancouver classification, and treatment. METHODS： A computer-based online search was performed in the Chinese National Knowledge Internet （CNKI） database, FMJS database and PubMed database from September 1994 to June 2012 for the literatures related to periprosthetic femoral fractures after total hip arthroplasty. The key words were ＂total hip arthroplasty, periprosthetic femoral fractures＂ in Chinese and English. The articles published earlier and repetitive researches were excluded. RESULTS AND CONCLUSION： Postoperative periprosthetic femoral fractures after total hip arthroplasty are increasing in frequency with the increasing numbers of total hip arthroplasty patients. The risk factors mainly include aging and gender of the patients, trauma, fixation pattern, prosthetic loosening, revision, osteolysis, diseases before replacement, osteoporosis, type of prosthesis, and surgical technique. It is very important to understand the risk factors involved for the prevention and treatment of periprosthetic femoral fractures. Vancouver classification of periprosthetic femoral fractures is based on the site and stability of fractures, prosthetic loosening, and proximal bone mass. This classification is very common in clinical practice. Clinical treatment should consider the type of fracture, loosening of the prosthesis and bone loss of proximal femur.

关 键 词：植入物 骨植入物 骨与关节综述 全髋关节置换 股骨假体周围骨折 危险因素 预防 Vancouver分型 假体松动 骨缺损 

分 类 号：R318[医药卫生—生物医学工程]