非骨水泥锥形楔形股骨髓内钉存在时的早期术后股骨假体周围骨折。
Early Post-operative Periprosthetic Femur Fracture in the Presence of a Non-cemented Tapered Wedge Femoral Stem.
机构信息
Department of Orthopaedic Surgery, Lenox Hill Hospital, William Black Hall, 11th Floor, 130 East 77th Street, New York, NY 10075 USA.
出版信息
HSS J. 2010 Sep;6(2):150-4. doi: 10.1007/s11420-010-9161-4. Epub 2010 Apr 2.
Abstract
Non-cemented femoral fixation in hip arthroplasty has become the standard of practice in the USA. However, recent literature has brought attention to an increasing incidence of periprosthetic femur fractures with certain stem designs. This study examines reasons for early periprosthetic femur fractures in patients with a hip arthroplasty performed using a non-cemented tapered wedge stem design. A multivariate analysis using a matched-cohort design was performed to assess any potential risk factors that may predispose to such fractures. Six of 2,220 hips (0.3%) suffered a periprosthetic femur fracture within the first year after surgery; five of six were Vancouver Type B2. The average time to fracture was 9 weeks. This group of patients had a significantly higher canal-flare index and lower canal-calcar ratio. This complication may be preventable by having a better appreciation of the fit between the implant and the bone during pre-operative planning, with the goal of avoiding a proximal-distal mismatch.
摘要
非骨水泥股骨固定在髋关节置换术中已成为美国的标准实践。然而，最近的文献引起了人们对某些柄设计的假体周围股骨骨折发生率增加的关注。本研究探讨了使用非骨水泥锥形楔形柄设计进行髋关节置换术后早期假体周围股骨骨折的原因。采用匹配队列设计的多变量分析评估了可能导致此类骨折的潜在风险因素。2220 例髋关节中有 6 例（0.3%）在手术后 1 年内发生假体周围股骨骨折；6 例中有 5 例为温哥华 B2 型。骨折的平均时间为 9 周。这组患者的髓腔-扩口指数明显较高，而髓腔-小粗隆比明显较低。通过更好地了解术前规划中植入物与骨骼之间的匹配情况，可以预防这种并发症，目标是避免远近端不匹配。
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2
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3
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J Arthroplasty. 2007 Jan;22(1):1-7. doi: 10.1016/j.arth.2006.03.003.
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7
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9
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