Raschke M J, Stange R, Kösters C
Klinik und Poliklinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Waldeyerstraße 1, 48149, Münster, Deutschland.
Unfallchirurg. 2012 Nov;115(11):1009-21. doi: 10.1007/s00113-012-2317-6.
Periprosthetic fractures are increasing not only due to the demographic development with high life expectancy, the increase in osteoporosis and increased prosthesis implantation but also due to increased activity of the elderly population. The therapeutic algorithms are manifold but general valid rules for severe fractures are not available. The most commonly occurring periprosthetic fractures are proximal and distal femoral fractures but in the clinical routine fractures of the tibial head, ankle, shoulder, elbow and on the borders to other implants (peri-implant fractures) and complex interprosthetic fractures are being seen increasingly more. It is to be expected that in the mid-term further options, such as cement augmentation of cannulated polyaxial locking screws will extend the portfolio of implants for treatment of periprosthetic fractures. The aim of this review article is to present the new procedures for osteosynthesis of periprosthetic fractures.
假体周围骨折不仅因预期寿命高的人口发展、骨质疏松症增加和假体植入增加而增多,还因老年人口活动增加所致。治疗算法多种多样,但尚无适用于严重骨折的通用有效规则。最常见的假体周围骨折是股骨近端和远端骨折,但在临床实践中,胫骨近端、踝关节、肩关节、肘关节以及与其他植入物交界处(植入物周围骨折)的骨折和复杂的假体间骨折越来越常见。预计在中期,诸如空心多轴锁定螺钉的骨水泥增强等更多选择将扩展用于治疗假体周围骨折的植入物种类。本文综述的目的是介绍假体周围骨折内固定的新方法。