Wehrli U
Chirurgische Abteilung, Zieglerspital, Bern.
Z Unfallchir Versicherungsmed. 1991;84(4):216-24.
INDICATIONS and results of the cement-free SL femoral stem. The SL femoral stem was designed to revise loosened femoral implants with extensive bone resorption and damage in the prosthetic bed. The stem bridges the damaged proximal area and the specific elasticity of the bridging part produces favourable conditions for new bone formation, whereas the distal section with 8 conical anchorage ribs allows a distal cementless fixation. Since 1987, 25 SL-revision stems were implanted at the Ziegler Hospital in Berne.
aseptic loosening with extensive bone loss = 16; periprosthetic femoral fractures = 6; Girdlestone after removal of infected THA = 2; unstable infected osteosynthesis of a proximal femoral fracture = 1. As described elsewhere, our revisions showed an impressive bone remodelling in the proximal femur damaged area with an osseointegration of the titanium stem, as could be shown histologically on a retrieved specimen of one of our cases. The Wagner stem proved to be an ideal implant to treat periprosthetic femur fractures in cases with loss of bone stock. The postoperative complications were low compared with the severity of the cases. Infections 0; aseptic loosening 1: replaced with a bigger and longer stem; luxations 4.
无骨水泥型SL股骨柄的适应证及结果。SL股骨柄旨在翻修假体床存在广泛骨吸收和破坏的松动股骨植入物。该股骨柄跨越受损的近端区域,其桥接部分的特定弹性为新骨形成创造了有利条件,而带有8个锥形锚固肋的远端部分可实现远端非骨水泥固定。自1987年以来,伯尔尼的齐格勒医院共植入了25个SL翻修股骨柄。
广泛骨质丢失的无菌性松动 = 16例;假体周围股骨骨折 = 6例;感染性全髋关节置换术后的Girdlestone手术 = 2例;近端股骨骨折不稳定感染性骨不连 = 1例。如其他地方所述,我们的翻修手术显示,在受损的股骨近端区域出现了令人印象深刻的骨重塑,钛柄实现了骨整合,这在我们其中一例取出的标本上通过组织学检查得以证实。对于骨量丢失病例,Wagner股骨柄被证明是治疗假体周围股骨骨折的理想植入物。与病例的严重程度相比,术后并发症较少。感染0例;无菌性松动1例:更换为更大更长的股骨柄;脱位4例。