人工髋关节置换术后股骨假体周围骨折治疗  

Treatment of periprosthetic femoral fracture after hip arthroplasty

作　　者：陈骁[1] 金毅[1] 程旭光[2] 张俊峰[2] 李寒曦[2] 郑稼[1] 

机构地区：[1]郑州大学人民医院河南省人民医院骨科,郑州450003 [2]新乡医学院,2012级河南新乡453000

出　　处：《中华实用诊断与治疗杂志》2015年第12期1218-1219,1222,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：2014年河南省重点科技攻关计划项目(142102310080)

摘　　要：目的 探讨髋关节置换术后股骨假体周围骨折（periprosthetic femoral fracture,PFF）治疗方法及疗效。方法 12例髋关节置换术后PFF患者,Vancouver分类B1型2例采用切开复位内固定或记忆合金环抱器固定术,B2型8例采用钢丝或钛缆环扎联合长柄全涂层假体翻修术,B3型1例采用长柄假体翻修联合异体骨板及自体松质骨移植术,C型1例采用解剖钢板切开复位内固定。结果 术后随访6-15个月,10例至末次随访时骨折达骨性愈合,1例B2型及1例B3型患者,术后6个月时骨折达临床愈合、或骨折端有大量骨痂形成;2例术后并发呼吸道感染、呼吸衰竭者均经对症治疗痊愈,2例术后出现异位骨化因不影响关节活动未予处理。结论 根据Vancouver分类并结合患者骨量情况、身体状况选择治疗方案,可有效治疗髋关节置换术后PFF。Objective To explore the surgical treatment and outcome of periprosthetic femoral fracture （PFF） after hip arthroplasty. Methods Twelve cases of PFF after hip arthroplasty were retrospectively analyzed. According to Vancouver classification, there were 2 cases of type B1, 8 cases of type B2, 1 case of type B3 and 1 case of type C. Type B1 patients underwent open reduction with internal fixation or shape memory alloy embracing fixator. Type B2 patients underwent ring-fastening steel wire or titanium cable plus long-stem cemented prosthesis revision. Type B3 patient underwent cortical strut allograft and the long-stem cemented prosthesis revision. Type G patient was underwent open reduction with internal fixation. Results All patients were followed up for 6 to 15 months. Ten cases got bone healing at the final follow-up. One patient in type B2 and type B3 got clinical healing or callus formation in 6 months. Two patients were complicated with respiratory tract infections and respiratory failure after operation, which were treated and healed after symptomatic treatment. Two patients with heterotopic ossification with no affect on joint motion received no treatment. Conclusion To choose surgical approaches based on Vancouver classification, bone mass and the physical condition of patients can effectively treat PFF after hip arthroplasty.

关 键 词：假体周围骨折 股骨 髋关节置换术 

分 类 号：R687.3[医药卫生—骨科学]