Maes Michael, Deboer Ytsje, Brabants Karl
Department of Orthopaedics and Trauma Surgery, ZNA Hospitals Middelheim, Antwerp, Belgium.
Acta Orthop Belg. 2012 Aug;78(4):552-7.
Metastatic lesions often occur in the trochanteric region of the femur with a risk for pathologic fractures, requiring aggressive surgical treatment. We present two cases of mechanical failure of the Titanium Gamma 3 Nail 180 used for treatment of impending pertrochanteric pathologic fractures. Metallurgic and low power optical examination findings are presented. Treatment with intramedullary nailing devices has proven its efficacy. However in cases of delayed union or non-union, a fatigue fracture due to dynamic overload should be expected sooner of later. If there is no evidence of healing within six months postoperatively a hardware exchange or another therapeutic option should be considered.
转移性病变常发生于股骨转子区，存在病理性骨折风险，需要积极的手术治疗。我们报告两例用于治疗转子周围即将发生的病理性骨折的180型钛伽马3钉出现机械故障的病例。文中展示了金相和低倍光学检查结果。髓内钉固定装置治疗已证明其有效性。然而，在延迟愈合或不愈合的情况下，迟早会出现因动态过载导致的疲劳骨折。如果术后六个月内没有愈合迹象，应考虑更换内固定装置或选择其他治疗方案。
