Zuber K, Jutzi J, Ganz R
Universitätsklinik für Orthopädische Chirurgie, Inselspital, Bern.
Unfallchirurg. 1992 May;95(5):240-2.
Fracture of the femoral shaft after hip arthroplasty is a serious problem. In most cases, minimal trauma is responsible for the fracture. Predisposing factors include severe osteoporosis, loosening of the prosthetic stem and perforations of the cortex. The incidence in our patient material in 2.3% after total hip arthroplasty and 2.9% after revision. Operative treatment may consist in osteosynthesis with compression plates, screws, or cerclage wires with or without revision of the arthroplasty. We give a case report covering treatment and 2-year follow-up for a bilateral proximal femoral fracture in a 72-year-old farmer with bilateral total hip replacements. Both fractures were treated similarly, with replacement of the femoral components by a cementless Wagner revision stem prosthesis and cerclage wiring of the fragments. No classic osteosynthesis was required to manage the fractures.
髋关节置换术后股骨干骨折是一个严重的问题。在大多数情况下，骨折由微小创伤所致。诱发因素包括严重骨质疏松、假体柄松动和皮质骨穿孔。在我们的患者资料中，全髋关节置换术后的发生率为2.3%，翻修术后为2.9%。手术治疗可包括使用加压钢板、螺钉或环扎钢丝进行骨接合术，可伴有或不伴有髋关节置换翻修。我们给出一例72岁双侧全髋关节置换的农民双侧股骨近端骨折的治疗及2年随访病例报告。两处骨折的治疗方式相似，采用非骨水泥型瓦格纳翻修柄假体置换股骨部件，并对骨折碎片进行环扎钢丝固定。处理骨折无需进行传统的骨接合术。
