全膝关节置换术后股骨假体周围骨折:附18例报告  

Periprosthetic Femoral Fractures after Total Knee Arthroplasty:Report of 18 Cases

作　　者：沈奕[1] 李晓淼[1] 丁裕润[1] 傅晓东[1] 王伟力[1] 

机构地区：[1]上海交通大学医学院附属仁济医院骨科,上海200127

出　　处：《中国临床医学》2014年第6期689-691,共3页Chinese Journal of Clinical Medicine

摘　　要：目的：探讨全膝关节置换术后股骨假体周围骨折的治疗方法及疗效。方法：2007年7月―2012年6月全膝关节置换术后Insall I/Ⅱ型股骨髁上骨折患者21例,其中18例获得随访,随访时间12~26个月（平均19.8个月）。18例患者中,5例（I型1例、ⅡA型2例、ⅡB型2例）采用非手术治疗,13例（I型1例、ⅡA型2例、ⅡB型10例）采用切开复位锁定钢板内固定术治疗。骨折后6个月,测量18例患者的膝关节活动范围、肢体力线,并采用美国特种外科医院膝关节评分（hospital for special surgery knee score,HSS）评定患者的膝关节功能。结果：18例患者的骨折均愈合,非手术患者的平均HSS评分为75.6分,手术治疗患者的平均HSS评分为85.08分。结论：采用切开复位锁定钢板内固定术治疗全膝关节置换术后股骨假体周围骨折的疗效较好。Objective：To investigate the treatment methods and efficacy of periprosthetic femoral fractures after total knee arthroplasty.Methods：A total of 21 patients with periprosthetic femoral fractures（Insall I or II）after total knee arthroplasty from2007 Jul to 2012 Jun were enrolled.There were 18 patients were followed for 12-26 monthes,with an average time of 19.8months.Among them,5 cases（Insall I 1,ⅡA2,ⅡB2）were treated conservatively,while the other 13 cases（Insall I 1,ⅡA2,ⅡB10）were treated with open reduction and internal fixation with a locking-plate.At 6 monthes after fracture,the range of motion,physical line of force were measured,and the knee function of all patients were assessed by hospital for special surgery knee score（HSS）.Results：The average HSS score was 75.6in5 patients treated conservatively,and 85.08in13 patients undergone operation.Conclusions：Open reduction and fixation inside with locking-plate is curative for periprosthetic femoral fractures after total knee arthroplasty.

关 键 词：股骨假体周围骨折 全膝关节置换术 复位 内固定 膝关节功能 

分 类 号：R683.42[医药卫生—骨科学]