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[使用帕特里奇方法对假体附近股骨骨折进行骨固定后的并发症]

[Complications after osteosynthesis using Partridge's method in femoral fracture near the prosthesis].

作者信息

Nafei A, Steinke N M, Saeter J, Thomsen P B

机构信息

Arhus Kommunehospital, Ortopaedkirurgisk Afdeling E.

出版信息

Ugeskr Laeger. 1990 Apr 9;152(15):1092-4.

PMID:2330631
Abstract

The object of the investigation is to illustrate the results and complications following Partridge's osteosynthesis of proximal fractures in the neighbourhood of the prosthesis. During a period of 40 months, eight consecutive patients (two men and six women) with proximal fractures of the femur in the neighbourhood of a hip prosthesis were subjected to osteosynthesis by Partridge's method. All of the fractures resulted from low energy trauma. The average age was 72 years (51-84) and the average duration of observation was 2.3 years. Weight-bearing was permitted after an average of 14.5 weeks and the radiographically assessed healing time was 16 weeks on an average. In all of the patients, cortical erosion developed under the Partridge bands 10-16 weeks postoperatively. In five patients, the initial erosions were of limited extent and were stationary during the period of observation. In three patients, the osteolysis was progressive and reoperation with introduction of a long-shafted femur prosthesis proved necessary. In addition, homologous boney transplants were necessary in two of these patients. Stability and healing of the fracture are obtained by osteosynthesis by Partridge's method but, on account of the osteolysis which is frequently pronounced and progressive, the patients should be followed-up meticulously in view of the possibility of removal of the Partridge material and possible replacement by a long-shafted femur prosthesis before the bone is completely eroded.

摘要

本研究的目的是阐述采用帕特里奇(Partridge)方法治疗假体周围近端骨折后的结果及并发症。在40个月的时间里,连续8例(2例男性和6例女性)髋关节假体周围股骨近端骨折患者接受了帕特里奇方法的骨固定术。所有骨折均由低能量创伤所致。平均年龄为72岁(51 - 84岁),平均观察期为2.3年。平均14.5周后允许负重,影像学评估的平均愈合时间为16周。所有患者术后10 - 16周在帕特里奇带下方出现皮质骨侵蚀。5例患者最初的侵蚀范围有限,在观察期内保持稳定。3例患者的骨溶解呈进行性发展,因此有必要再次手术,植入长柄股骨假体。此外,其中2例患者还需要进行同种异体骨移植。采用帕特里奇方法进行骨固定可获得骨折的稳定性和愈合,但由于骨溶解常常明显且呈进行性发展,鉴于可能需要在骨质完全侵蚀之前取出帕特里奇材料并可能更换为长柄股骨假体,应对患者进行细致的随访。

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