Department of Orthopedic Surgery, Kyungpook National University School of Medicine, Daegu, Korea.
Clin Orthop Surg. 2011 Jun;3(2):101-6. doi: 10.4055/cios.2011.3.2.101. Epub 2011 May 12.
We analyzed the radiological and clinical results of our study subjects according to the management algorithm of the Vancouver classification system for the treatment of periprosthetic femoral fractures in hip arthroplasty.
We retrospectively reviewed 18 hips with postoperative periprosthetic femoral fractures. The average follow-up was 49 months. The fracture type was determined based on the Vancouver classification system. The management algorithm of the Vancouver classification system was generally applied, but it was modified in some cases according to the surgeon's decision. At the final follow-up, we assessed the radiological results using Beals and Tower's criteria. The functional results were also evaluated by calculating the Harris hip scores.
Seventeen of 18 cases (94.4%) achieved primary union at an average of 25.5 weeks. The mean Harris hip score was 92. There was 1 case of nonunion, which was a type C fracture after cemented total hip arthroplasty, and this required a strut allograft. Subsidence was noted in 1 case, but the fracture was united despite the subsidence. There was no other complication.
Although we somewhat veered out of the management algorithm of the Vancouver classification system, the customized treatment, with considering the stability of the femoral stem and the configuration of the fracture, showed favorable overall results.
我们根据温哥华分类系统治疗髋关节置换术后股骨假体周围骨折的管理算法，对研究对象的影像学和临床结果进行了分析。
我们回顾性分析了 18 例髋关节置换术后股骨假体周围骨折患者。平均随访 49 个月。根据温哥华分类系统确定骨折类型。一般采用温哥华分类系统的管理算法，但根据术者的决定，在某些情况下进行了修改。在最终随访时，我们根据 Beals 和 Tower 的标准评估影像学结果。通过计算 Harris 髋关节评分评估功能结果。
18 例中 17 例（94.4%）在平均 25.5 周时达到一期愈合。平均 Harris 髋关节评分为 92 分。1 例发生骨不连，为骨水泥全髋关节置换后 C 型骨折，需要使用支撑异体骨移植。1 例出现沉降，但骨折仍愈合，尽管有沉降。无其他并发症。
尽管我们在一定程度上偏离了温哥华分类系统的管理算法，但考虑到股骨柄的稳定性和骨折的形态，这种定制化的治疗方法显示出了良好的总体结果。
