Hsieh Pang-Hsin, Chang Yu-Han, Lee Po-Cheng, Shih Chun-Hsiung
Department of Orthopedics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Acta Orthop. 2005 Aug;76(4):538-43. doi: 10.1080/17453670510041538.
Periprosthetic fractures of the greater trochanter through osteolytic cysts are rare. The proper treatment and its influence on the prosthetic survival remains unknown.
We retrospectively evaluated 887 hips with uncemented MicroStructured Omnifit total hip prostheses at a mean follow-up time of 11 (5-14) years. We found 23 (2.6%) fractures of the greater trochanter through a cystic lesion, occurring 4-11 years postoperatively.
Nonoperative treatment healed 15 of the 17 fractures that were minimally displaced. At a mean follow-up of 3 (2-5) years after the fracture, 16 had had revision of the components because of excessive wear, loosening, or nonunion.
We conclude that a periprosthetic fracture of the greater trochanter through an osteolytic lesion is usually stable and heals without treatment. However, it is associated with poor prosthetic survival because of excessive polyethylene wear.
通过溶骨性囊肿发生的大转子假体周围骨折很罕见。恰当的治疗方法及其对假体生存率的影响尚不清楚。
我们回顾性评估了887例采用非骨水泥型微结构全适配全髋关节假体的髋关节，平均随访时间为11（5 - 14）年。我们发现23例（2.6%）通过囊性病变发生的大转子骨折，发生于术后4 - 11年。
17例移位极小的骨折中有15例通过非手术治疗愈合。骨折后平均随访3（2 - 5）年时，16例因聚乙烯过度磨损、松动或骨不连而进行了假体翻修。
我们得出结论，通过溶骨性病变发生的大转子假体周围骨折通常是稳定的，无需治疗即可愈合。然而，由于聚乙烯过度磨损，其与假体生存率低有关。
