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[人工关节周围骨折。钢板内固定稳定后的长期结果]

[Periprosthetic fractures. Long-term results after plate osteosynthesis stabilization].

作者信息

Rupprecht M, Grossterlinden L, Barvencik F, Gebauer M, Briem D, Rueger J M, Lehmann W

机构信息

Klinik und Poliklinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinik Hamburg Eppendorf, Hamburg, Deutschland.

出版信息

Unfallchirurg. 2008 Oct;111(10):812-20. doi: 10.1007/s00113-008-1470-4.

Abstract

BACKGROUND

Due to the increasing age of patients and the rising number of joint replacements, the incidence of periprosthetic fractures (PPF) is also increasing. The treatment should be selected with knowledge of the prefracture interface status and the type of fracture involved. The aim of this study was to evaluate our treatment of PPF with long-term follow-up.

PATIENTS AND METHODS

From 1988 to 2006, 99 patients with PPF were treated in our department. In 86 cases a plate osteosynthesis was used. After a mean time of 7.3+/-2.8 years, we studied 56 patients and monitored their complications.

RESULTS

The most diagnosed fracture was Johansson type III (44%). Seventy-one patients were treated with a conventional and 15 with locking-plate osteosynthesis. In 15 cases (17.5%) we found severe complications (3 breaks and 3 dislocations of the plates, 6 cases of pseudarthrosis, 2 deep wound infections, and 1 case of postoperative bleeding).

CONCLUSION

Due to the minor frequency of severe complications, plate osteosynthesis of a periprosthetic fracture with a loosened interface is a good therapeutic option for individual patients, particularly for geriatric patients and those without disorders specific to a loosened interface.

摘要

背景

由于患者年龄增长以及关节置换数量增加,假体周围骨折(PPF)的发生率也在上升。治疗方法应根据骨折前界面状态和骨折类型来选择。本研究的目的是对PPF的治疗进行长期随访评估。

患者与方法

1988年至2006年,我科共治疗99例PPF患者。其中86例采用钢板内固定。平均7.3±2.8年后,我们对56例患者进行研究并监测其并发症。

结果

最常见的骨折类型为约翰松III型(44%)。71例患者采用传统钢板内固定,15例采用锁定钢板内固定。15例(17.5%)出现严重并发症(3例钢板断裂、3例钢板脱位、6例骨不连、2例深部伤口感染和1例术后出血)。

结论

由于严重并发症发生率较低,对于假体周围骨折且界面松动的患者,尤其是老年患者和无界面松动特定疾病的患者,钢板内固定是一种较好的治疗选择。

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