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髋关节置换术后模块化股骨颈组件骨折。

Fracture of the modular femoral neck component in total hip arthroplasty.

机构信息

Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois 60612, USA.

出版信息

J Arthroplasty. 2013 Jan;28(1):196.e1-5. doi: 10.1016/j.arth.2011.05.024. Epub 2011 Jul 27.

Abstract

The use of modularity, specifically dual modular femoral stems, in total hip arthroplasty has increased in popularity over the past 2 decades. While offering several distinct advantages intraoperatively, the long-term success of adding a second modular junction has yet to be established. One potential complication of increasing modularity is component fracture. We present a case of modular femoral neck prosthesis fracture necessitating revision surgery to treat this complication. Careful preoperative planning during revision of these failures is essential to avoid morbidity and unnecessary subsequent revision surgeries, as demonstrated in this case. The combined effects of crevice and fretting corrosion, large-diameter femoral head, long modular neck, metal-on-metal articulation, patient size, and activity level may have all played integral roles in creating an environment susceptible to this classic pattern of fatigue fracture.

摘要

在过去的 20 年中,使用模块化设计,特别是双模块化股骨柄,在全髋关节置换术中越来越受欢迎。虽然在手术中提供了几个明显的优势,但增加第二个模块化连接的长期效果尚未确定。增加模块化设计的一个潜在并发症是部件断裂。我们报告了一例因模块化股骨颈假体骨折而需要翻修手术的病例,以治疗这种并发症。在这些失败的翻修手术中,仔细的术前规划是至关重要的,以避免发病率和不必要的后续翻修手术,正如本例所示。缝隙和微动腐蚀、大直径股骨头、长模块化颈部、金属对金属关节、患者体型和活动水平的综合作用可能都在创造一个容易发生这种经典疲劳断裂模式的环境中发挥了重要作用。

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