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中国一种形状记忆合金内固定器治疗髋臼骨折的应用:随访 2 至 9 年的结果。

Application of a shape-memory alloy internal fixator for treatment of acetabular fractures with a follow-up of two to nine years in China.

机构信息

Department of Orthopaedic Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, China.

出版信息

Int Orthop. 2010 Oct;34(7):1033-40. doi: 10.1007/s00264-009-0867-1. Epub 2009 Dec 11.

Abstract

Displaced acetabular fractures should be treated surgically. Over the past decade, surgical approaches to the acetabulum and the surgical technique for repair of common fracture patterns have advanced. Excellent outcomes after repair of these injuries can be achieved. The aim of this study was to assess the medium-term results of reconstruction of acetabular fractures by using shape-memory alloy designed by the authors. This is a retrospective review conducted at a level 1 trauma centre. From October 1999 to July 2009, 19 patients with acetabular fractures were treated with our patented Ni-Ti shape-memory alloy acetabular tridimensional memory alloy-fixation system (ATMFS). The ATMFS device was cooled with ice before implantation and then warmed to 40-50°C after implantation to produce balanced axial and compression forces that would stabilise the fracture three dimensionally. Our results are as follows; according to the D'Aubigne-Postel scoring system: Fifteen cases out of 19 (79%) achieved excellent or good clinical results. In two patients, late complications included avascular necrosis of the femoral head (ANFH) associated with posterior dislocation of the hip joint two years after the operation. We also observed two cases of grade II or III ectopic ossification, with good hip function, and one case of traumatic arthritis. In conclusion, these results demonstrate the effectiveness of the ATMFS device for the management of acetabular fracture. The device provides continuous compression of the fracture with minimal disruption to the local blood supply.

摘要

移位性髋臼骨折应采用手术治疗。在过去的十年中,髋臼的手术入路和常见骨折模式的修复技术都有了进步。这些损伤修复后的良好效果是可以实现的。本研究的目的是评估作者设计的形状记忆合金修复髋臼骨折的中期结果。这是在 1 级创伤中心进行的回顾性研究。1999 年 10 月至 2009 年 7 月,19 例髋臼骨折患者采用我们专利的 Ni-Ti 形状记忆合金髋臼三维记忆合金固定系统(ATMFS)治疗。在植入前,ATMFS 装置用冰冷却,然后在植入后加热到 40-50°C,以产生平衡的轴向和压缩力,从而使骨折三维稳定。我们的结果如下:根据 D'Aubigne-Postel 评分系统:19 例中有 15 例(79%)获得了优秀或良好的临床结果。在 2 例患者中,晚期并发症包括术后 2 年髋关节后脱位伴股骨头缺血性坏死(ANFH)。我们还观察到 2 例 2 级或 3 级异位骨化,髋关节功能良好,1 例创伤性关节炎。总之,这些结果表明 ATMFS 装置在髋臼骨折治疗中的有效性。该装置提供了对骨折的持续压缩,对局部血供的干扰最小。

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