El-Zayat B F, Zettl R, Efe T, Krüger A, Eisenberg F, Ruchholtz S
Klinik für Orthopädie und Rheumatologie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Baldingerstraße, Marburg, Germany.
Unfallchirurg. 2012 Feb;115(2):134-44. doi: 10.1007/s00113-010-1871-z.
Periprosthetic femur fractures in elderly patients are a challenging surgical procedure. The aim of this study was a prospective evaluation of minimally invasive implantation of non-contact bridging (NCB-DF®) plates.
A total of 30 osteosynthesis procedures in 29 patients (average age 76 years and mean ASA 2.9) with complex femur fractures were registered, 19 fractures were periprosthetic and osteoporosis was present in 17 bones. In 25 patients a minimally invasive percutaneous procedure was performed using a standardized technique. An x-ray examination and clinical follow-up were performed after 6, 12 and 24 weeks.
The early complications (14% in total) included 1 plate breakage after 16 weeks as well as 3 minor revisions for screw length correction. The x-ray follow-up after 24 weeks showed a secondary extension deficit of 10° and 15° in the knee joint in 2 patients, respectively.
The NCB-DF® implantation using a standardized minimally invasive technique in periprosthetic femur fractures is a safe alternative in elderly patients. In this very sensitive population the early revision rate within the first 24 weeks is noticeable lower compared to similar procedures.
老年患者的股骨假体周围骨折是一项具有挑战性的外科手术。本研究的目的是对非接触式桥接（NCB-DF®）钢板的微创植入进行前瞻性评估。
共记录了29例患者（平均年龄76岁，平均ASA分级为2.9）的30例复杂股骨骨折的接骨术，其中19例为假体周围骨折，17例存在骨质疏松。25例患者采用标准化技术进行了微创经皮手术。在术后6周、12周和24周进行了X线检查和临床随访。
早期并发症（总计14%）包括16周后1例钢板断裂以及3例因螺钉长度校正进行的小修正手术。24周后的X线随访显示，2例患者膝关节分别出现10°和15°的继发性伸展受限。
在股骨假体周围骨折中，采用标准化微创技术植入NCB-DF®钢板对老年患者是一种安全的选择。在这个非常敏感的人群中，与类似手术相比，24周内的早期翻修率明显较低。
