Wang Jun-Wen, Wang Ching-Jen
Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chang Gung University, Kaohsiung, Taiwan.
J Orthop Surg (Hong Kong). 2000 Jun;8(1):27-31. doi: 10.1177/230949900000800106.
Between 1993 and 1998, 15 patients with periprosthetic fractures of the femur after hip arthroplasty were treated using deep-frozen cortical strut allografts as an adjunct support after internal fixation or revision arthroplasty. According to the Vancouver classification system, there were 7 type B1, 2 type B2, 4 type B3 and 2 type C fractures. Seven patients had severe osteopenia, 10 patients had bone defects between 2 to 7 cm and 2 were associated with infection. Nine patients had internal fixation of the fracture using a compression plate, and 6 had revision arthroplasty using a long-stemmed femoral prosthesis. The average length of the allograft was 13.9 cm. At an average follow-up of 31 months, all the patients had a satisfactory functional result except one who had a leg length discrepancy of 4 cm due to multiple operations. There were no non-unions, malunions or infections. The fractures healed between 10 to 24 weeks (average, 15.6 weeks). In conclusion, a cortical strut allograft associated with internal fixation can be an effective method of treating periprosthetic fractures of the femur after hip arthroplasty.
1993年至1998年间，15例髋关节置换术后股骨假体周围骨折患者在切开复位内固定或翻修置换术后，采用深冻皮质支撑异体骨作为辅助支撑进行治疗。根据温哥华分类系统，有7例B1型、2例B2型、4例B3型和2例C型骨折。7例患者有严重骨质减少，10例患者骨缺损在2至7厘米之间，2例伴有感染。9例患者采用加压钢板进行骨折内固定，6例采用长柄股骨假体进行翻修置换。异体骨平均长度为13.9厘米。平均随访31个月时，除1例因多次手术导致双下肢长度相差4厘米外，所有患者功能结果均令人满意。无骨不连、畸形愈合或感染发生。骨折在10至24周（平均15.6周）内愈合。总之，皮质支撑异体骨联合内固定可能是治疗髋关节置换术后股骨假体周围骨折的有效方法。
