Talmo Carl T, Sambaziotis Chris, Bono James V
Orthopedics. 2013 Sep;36(9):693-6. doi: 10.3928/01477447-20130821-04.
Hip arthroplasty after open reduction and internal fixation of the proximal femur presents a challenge to reconstructive surgeons. Bony defects, fracture malunion, and non-union increase the risk of complications, including intraoperative fracture, unrecognized perforation, and trochanteric non-union. The authors describe a novel surgical technique using conversion hemiarthroplasty and valgus osteotomy for failed open reduction and internal fixation of intertrochanteric hip fractures. The described surgical technique resulted in trochanteric advancement and preservation of the bone stock in the intertrochanteric region. This technique was successful in eliminating pain and restoring ambulation and abductor function and resulted in stable ingrowth and healing in these patients.
股骨近端切开复位内固定术后的髋关节置换术给重建外科医生带来了挑战。骨缺损、骨折畸形愈合和不愈合会增加并发症的风险,包括术中骨折、未被识别的穿孔和转子不愈合。作者描述了一种新颖的手术技术,即采用转换半髋关节置换术和外翻截骨术来治疗转子间髋部骨折切开复位内固定失败的情况。所描述的手术技术实现了转子推进并保留了转子间区域的骨量。该技术成功消除了疼痛,恢复了行走和外展肌功能,并使这些患者实现了稳定的骨长入和愈合。