Agarwal Sanjeev, Andrews C M, Bakeer G M
Scarborough Hospital, North Yorkshire, YO12 6QL, United Kingdom.
J Arthroplasty. 2005 Jan;20(1):118-21. doi: 10.1016/j.arth.2004.03.021.
We present results of internal stabilization of 16 type B1 periprosthetic femoral fractures following total or hemiarthroplasty of the hip. Seven patients had cemented stems, and the rest had cementless, extensively hydroxyapatite-coated stems. Fourteen were managed by a cable-grip plating system, 1 by Dynamic compression plate, and 1 had insertion of cables only. Minimum follow-up was 1 year. Four patients had a major complication: 2 had deep infection; 1 had nonunion requiring amputation; and 1 had persistent hip pain requiring removal of all metalwork, including the hip prosthesis. The average time to healing in the remaining patients was 16.3 weeks. Harris Hip Scores dropped from an average of 86.8 preoperatively to 73.4 on last follow-up. Periprosthetic fractures are a significant injury, with a high risk of complications.
我们展示了16例髋关节全置换或半置换术后B1型股骨假体周围骨折行内固定术的结果。7例患者使用骨水泥型股骨柄,其余患者使用非骨水泥型、广泛羟基磷灰石涂层股骨柄。14例采用缆索式钢板固定系统治疗,1例采用动力加压钢板治疗,1例仅植入缆索。最短随访时间为1年。4例患者出现严重并发症:2例发生深部感染;1例骨不连需截肢;1例持续髋关节疼痛,需取出包括髋关节假体在内的所有金属植入物。其余患者的平均愈合时间为16.3周。Harris髋关节评分从术前平均86.8降至末次随访时的73.4。假体周围骨折是一种严重损伤,并发症风险高。