钢板钛缆固定Vancouver B1型股骨假体周围骨折  

Plate combined with titanium cable cerclage fixation for Vancouver type B1 periprosthetic femoral fractures

作　　者：文祖洲 叶赟 吴西智 周华 陈洪强[1] WEN Zuzhou;YE Yun;WU Xi-zhi;ZHOU Hua;CHEN Hong-qiang(Department of Joint Surgery,Guiyang Fourth People's Hospital,Guiyang,Gui-zhou 550002,China)

机构地区：[1]贵阳市第四人民医院关节外科,贵州贵阳550002

出　　处：《中国矫形外科杂志》2025年第3期274-277,共4页Orthopedic Journal of China

摘　　要：[目的]探讨锁定钢板钛缆固定Vancouver B1型股骨假体周围骨折的临床疗效。[方法]回顾性分析2021年8月—2023年3月本院采用锁定钢板钛缆治疗的9例Vancouver B1型股骨假体周围骨折患者的临床资料,评估术后临床及影像学结果。[结果]所有患者均顺利完成手术,术中无血管、神经损伤等严重并发症。手术时间平均(95.1±15.8)min,术中出血量平均(622.2±272.9)ml,住院时间平均(12.9±4.8)d;随访时间平均(15.3±5.3)个月;与术前相比,术后3个月及末次随访时VAS评分[(8.7±1.2),(4.8±1.1),(0.7±0.7),P<0.001]显著减少,髋-伸屈ROM[(10.3±6.0)°,(88.2±8.3)°,(111.4±6.0)°,P<0.001]、内-外旋ROM[(3.8±2.5)°,(20.4±4.0)°,(39.6±3.2)°,P<0.001]及Harris评分[(21.3±7.8),(72.1±5.3),(89.3±7.7),P<0.001]显著增加。影像方面,股骨对线[例,优/良/可/差,(0/0/2/7),(9/0/0/0),(9/0/0/0),P<0.001]及股骨假体位置[例,优/良/可/差,(0/0/1/8),(9/0/0/0),(9/0/0/0),P<0.001]显著改善。[结论]锁定钢板钛缆固定Vancouver B1型股骨假体周围骨折近期疗效满意,术后患肢髋关节功能恢复良好。[Objective]To investigate the clinical consequence of locking plate combined with titanium cable cerclage for fixation of Vancouver type B1 periprosthetic femoral fractures.[Methods]A retrospective study was done on 9 patients who had Vancouver type B1 periprosthetic femoral fractures treated by locking plate combined with titanium cable cerclage in our hospital from August 2021 to March 2023.The clinical and imaging document were evaluated.[Results]All the patients had revision performed successfully with no vascular and nerve injuries and other serious complications during the operation,whereas with the average operation time of(95.1±15.8)min,intraoperative blood loss of(622.2±272.9)ml,and hospital stay of(12.9±4.8)days,and were followed up for(15.3±5.3)months in an average.With time from that before revision,3 months preoperatively to the latest follow-up,the VAS[(8.7±1.2),(4.8±1.1),(0.7±0.7),P<0.001]significantly reduced,while the hip flexion-extension range of motion(ROM)[(10.3±6.0)°,(88.2±8.3)°,(111.4±6.0)°,P<0.001],internal-external rotation ROM[(3.8±2.5)°,(20.4±4.0)°,(39.6±3.2)°,P<0.001]and the Harris score[(21.3±7.8),(72.1±5.3),(89.3±7.7),P<0.001]significantly increased.As for imaging,the femoral alignment[case,excellent/good/fair/poor,(0/0/2/7),(9/0/0/0),(9/0/0/0),P<0.001]and the femoral prosthetic position[case,excellent/good/fair/poor,(0/0/1/8),(9/0/0/0),(9/0/0/0),P<0.001]significantly improved over time.[Conclusion]The locking plate and titanium cable cerclage used for fixation of Vancouver type B1 periprosthetic femoral fractures achieve satisfactory shortterm outcomes,with the hip function of the affected limb recovered well.

关 键 词：假体周围骨折 股骨 锁定钢板 钛缆环扎 

分 类 号：R683.42[医药卫生—骨科学]