Engh C Anderson, Hopper Robert H, Engh Charles A
Anderson Orthopaedic Research Institute, PO Box 7088, Alexandria, VA 22306, USA.
Clin Orthop Relat Res. 2004 Mar(420):135-41. doi: 10.1097/00003086-200403000-00019.
The literature documents that distal ingrowth fixation provides a reproducible, durable option that can be used in many femoral revision situations. In this review, we describe our use of cylindrical, extensively porous-coated stems to achieve distal fixation. The procedure involves choosing 5 cm to 7 cm of diaphyseal bone and reaming it cylindrically for a porous-coated femoral stem. Surgical implantation is uncomplicated because the femoral diaphysis aligns the component and imparts a reproducible press-fit sensation during impaction. The complications are well documented and can be avoided with adequate exposure, intraoperative radiographs, and surgical experience. Survivorship data based on femoral revisions done at our institution with extensively porous-coated stems show overall excellent results although a relatively poorer outcome is associated with patients whose prerevision cortical damage involves bone more than 10 cm below the lesser trochanter.
文献记载，远端植入固定提供了一种可重复、持久的选择，可用于多种股骨翻修情况。在本综述中，我们描述了使用圆柱形、广泛多孔涂层柄来实现远端固定。该手术包括选择5厘米至7厘米的骨干骨，并将其圆柱形扩髓以植入多孔涂层股骨干柄。手术植入并不复杂，因为股骨干可使假体部件对齐，并在打入过程中产生可重复的压配感觉。并发症有充分的文献记载，通过充分暴露、术中X线片和手术经验可以避免。基于我们机构使用广泛多孔涂层柄进行股骨翻修的生存数据显示，总体结果良好，尽管对于翻修前皮质骨损伤累及小转子以下超过10厘米骨骼的患者，结果相对较差。
