Stuchin S A
Arthritis Management Service, New York University School of Medicine, New York.
Orthop Rev. 1990 Feb;19(2):153-9.
Press-fit and porous femoral components for total hip replacements are currently designed for aggressive canal filling. The bulk of the implants and their manner of insertion have created new femoral fracture problems in hip arthroplasty. Sixteen femoral fractures occurred in a series of 79 press-fit or porous arthroplasties in 72 patients. All cases in this report were reviewed through the period of fracture healing. The fractures were classified as follows: type I, at the neck medially, or proximal to the isthmus laterally; type II, running in a spiral oblique pattern from the stem tip; type III, originating in stress risers in the femoral shaft; and type IV, miscellaneous unclassifiable fractures. All fractures healed, leaving painless hips (Harris hip score average, 84). Collared implants are recommended in proximal fractures to protect against acute subsidence due to a wedging mechanism.
目前，用于全髋关节置换的压配式和多孔股骨部件设计用于积极填充髓腔。植入物的主体及其插入方式在髋关节置换术中引发了新的股骨骨折问题。在72例患者的79例压配式或多孔关节置换术中发生了16例股骨骨折。本报告中的所有病例均在骨折愈合期间进行了复查。骨折分类如下：I型，位于内侧颈部，或外侧峡部近端；II型，从柄尖呈螺旋斜形延伸；III型，起源于股骨干的应力集中处；IV型，其他无法分类的骨折。所有骨折均愈合，髋关节无痛（Harris髋关节评分平均为84分）。对于近端骨折，建议使用带颈植入物，以防止因楔入机制导致的急性下沉。
