钢板结合异体骨板对粉碎性Vancouver B1型假体周围股骨骨折的疗效观察  

Treatment of Vancouver type B1 periprosthetic femoral fracture with locked plate and xenogenic bony plate

作　　者：陈奇[1] 陈卫[1] 丁真奇[1] 刘国浚 高建廷[1] 刘炎[1] 

机构地区：[1]解放军第175医院全军创伤骨科中心,福建漳州363000

出　　处：《中国骨伤》2016年第8期734-737,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的 ：观察钢板结合异体骨板对严重粉碎性Vancouver B1型假体周围股骨骨折的疗效,评价其效果。方法：2006年1月至2013年1月采用钢板-钢丝系统结合异体骨板治疗严重粉碎性Vancouver B1型股骨假体周围骨折患者8例,男6例,女2例;年龄56~74岁,平均62.52岁。所有患者采用长的钢板、钢丝及长度合适的异体骨板。以Harris评分标准对患者手术前后髋关节功能进行评估,通过数字化X线摄片技术对假体稳定性、异体骨板愈合情况进行评估。结果：8例患者获得随访,时间24~60个月,平均45个月,所有患者骨折愈合,未出现感染、松动、骨折不愈合及畸形愈合。Harris评分由术前的（28.45±5.78）分提高至术后的（83.46±10.21）分。至随访结束,7例患者假体稳定,异体骨板愈合良好;另1例患者因假体松动行翻修术。结论：应用钢板-钢丝系统结合异体骨板对严重粉碎性Vancouver B1型假体周围股骨骨折进行手术操作简便,并发症少,术后髋关节功能恢复良好,可以提高骨的质量,增加骨量,为Ⅱ期可能的翻修提供有利条件。Objective：To analyze the therapeutic effect of plate cable system and cortical strut bone graft in the prosthesis revision of the total hip arthroplasty for the treatment of Vancouver type B1 periprosthetic femoral fracture. Methods：A total of8 patients were selected from January 2006 to January 2013,including 6 males and 2 females,aged from 56 to 74 years old（62.52 years old on average）. All the cases were treated by the long plate cable system and appropriate cortical strut bone graft. Harris score was used to evaluate the hip functions before and after the operation. Prosthesis stability and the bony union were assessed by the digital radiography. Results：All the patients were followed up for 45 months on average ranging from 24 to 60 months after operation. All the fractures reached union,and there was no infection,stem loosening,nonunion and malunion. The Harris score was 28.45±5.78 before operation,which was improved to 83.46±10.21 after operation. X ray showed that the prosthesis was stable,and the host bone and bone graft achieved bony union in 7 patients;and the other 1 patient need further operation of revision around the loose stem. Conclusion：The prosthesis revision of the total hip arthroplasty with the locking plate and cortical strut bone graft used for the Vancouver type B1 periprosthetic proximal femur fractures has the advantages of simple manipulation,less complications,good recovery of the hip function and can improve bone quality to provide favorable conditions for operation of revision.

关 键 词：关节成形术 置换 髋 假体周围骨折 骨移植 股骨骨折 

分 类 号：R683.42[医药卫生—骨科学]