Department of Orthopaedic Surgery, Medical University of South Carolina, Charleston, South Carolina 29425, USA.
J Arthroplasty. 2012 May;27(5):783-8. doi: 10.1016/j.arth.2011.08.019. Epub 2011 Oct 19.
Several techniques are described for fixation of Vancouver B1 femoral shaft fractures after total hip arthroplasty. Twenty-four femurs were scanned by dual x-ray absorptiometry scanned and matched for bone mineral density. Femurs were implanted with a cemented simulated total hip prosthesis with a simulated periprosthetic femur fracture distal to the stem. Fractures were fixed with Synthes (Paoli, Pa) 12-hole curved plates and 4 different constructs proximally. Each construct was loaded to failure in axial compression. Constructs with locking and nonlocking screws demonstrated equivalent loads at failure and were superior in load at failure compared with cables. Cable constructs failed proximally. No proximal failures occurred in specimens fixed with screws and cables. A combination of locked or nonlocked screws and supplemental cable fixation is recommended for the treatment of Vancouver B1 periprosthetic femur fractures.
描述了几种技术用于固定全髋关节置换术后温哥华 B1 股骨干骨折。对 24 个股骨进行双能 X 线吸收扫描，并对骨密度进行匹配。将股骨植入带柄的模拟全髋关节假体，假体周围股骨骨折位于柄的远端。骨折采用 Synthes（宾夕法尼亚州保利）12 孔弯钢板和 4 种不同的近端固定方式固定。每个固定装置都在轴向压缩下加载至失效。带锁定和非锁定螺钉的固定装置在失效时的负载相等，并且比电缆在失效时的负载更高。电缆固定装置在近端失效。用螺钉和电缆固定的标本没有近端失效。推荐使用锁定或非锁定螺钉和附加电缆固定的组合来治疗温哥华 B1 假体周围股骨骨折。
