Kääb M J, Stöckle U, Schütz M, Stefansky J, Perka C, Haas N P
Center for Musculosceletal Surgery, Charité Universitätsmedizin Berlin, Schumannstrasse 20, Berlin, Germany.
Arch Orthop Trauma Surg. 2006 Mar;126(2):105-10. doi: 10.1007/s00402-005-0075-4. Epub 2005 Dec 23.
Periprosthetic fractures of the femur present a challenging surgical problem. The aim of this study was to retrospectively evaluate the outcome of periprosthetic fractures stabilised with an angular stable, less invasive stabilisation system (LISS).
Thirteen patients (ten total hip-, two total knee-, one total hip- and knee-arthroplasty) with periprosthetic fractures were treated with the LISS internal fixator (in ten cases minimal invasive). Six patients had previous operations due to periprosthetic fractures. The average follow-up period was 20 months, follow-up rate 85%.
All fractures showed radiographic fracture healing without implant loosening. Except one patient, all patients had returned to their pre-operative activity level. No early post-operative complications were seen. There was one implant failure after 4 months and two cases of malunion.
The cases showed the internal fixator to be effective for the stabilisation of periprosthetic fractures, even in cases of poor bone quality with good functional outcomes. The internal fixator, with the option of minimal invasive application, is the preferred method of osteosynthesis in periprosthetic fractures.
股骨假体周围骨折是一个具有挑战性的外科问题。本研究的目的是回顾性评估采用角稳定、微创稳定系统（LISS）固定的假体周围骨折的治疗结果。
13例假体周围骨折患者（10例全髋关节置换、2例全膝关节置换、1例全髋关节和膝关节置换）接受了LISS内固定器治疗（10例为微创）。6例患者曾因假体周围骨折接受过手术。平均随访时间为20个月，随访率为85%。
所有骨折均显示影像学骨折愈合，无植入物松动。除1例患者外，所有患者均恢复到术前活动水平。术后未出现早期并发症。4个月后出现1例植入物失败，2例骨不连。
这些病例表明，内固定器对假体周围骨折的固定有效，即使在骨质量较差的情况下，功能结果也良好。具有微创应用选项的内固定器是假体周围骨折骨合成的首选方法。
