Academic Department of Trauma and Orthopaedic Surgery, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, School of Medicine, Leeds University, Great George Street, Leeds, LS1 3EX, UK.
J Arthroplasty. 2010 Sep;25(6):939-44. doi: 10.1016/j.arth.2009.06.034. Epub 2009 Sep 23.
Periprosthetic femoral fractures around a total knee arthroplasty present a surgical challenge in octogenarians with advanced osteoporosis. We describe a salvage technique combining retrograde intramedullary nailing augmented with polymethylmethacrylate cement in 5 patients followed up for a median time of 12 months. The nail/cement construct bridges the femoral canal tightly and simulates a stemmed cemented revision component. All patients had an uncomplicated recovery and returned to their preinjury functional status within 4 months. This procedure does not disrupt the soft tissue envelope around the fracture site, is easy to perform and permits immediate full range of movement. When standard retrograde nailing or plating alone is inadequate in maintaining severely osteoporotic fracture reduction, nailed cementoplasty is proposed as a salvage procedure in octogenarians unfit for lengthy interventions.
全膝关节置换术后股骨假体周围骨折在伴有严重骨质疏松的 80 岁以上老年人中是一个手术挑战。我们描述了 5 例患者采用逆行髓内钉联合聚甲基丙烯酸甲酯骨水泥补救技术治疗的情况，随访中位数时间为 12 个月。钉/水泥结构紧密桥接股骨髓腔，模拟带柄水泥固定翻修组件。所有患者均恢复顺利，4 个月内恢复到术前的功能状态。该手术不会破坏骨折部位周围的软组织包膜，操作简单，可立即进行全范围活动。当标准逆行髓内钉或钢板固定不足以维持严重骨质疏松性骨折复位时，对于不适合长时间干预的 80 岁以上老年人，可采用钉骨水泥成形术作为补救手术。
