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全膝关节置换术后假体周围股骨远端骨折的微创钢板接骨术

Minimally invasive plate osteosynthesis for periprosthetic distal femoral fractures after total knee arthroplasty.

作者信息

Ha Chul-Wung, Shon Oog Jin, Lim Seung Wan, Park Kang Hyun

机构信息

Department of Orthopaedic Surgery, Yeungnam University Medical Center, Daegu, Korea.

出版信息

Knee Surg Relat Res. 2014 Mar;26(1):27-32. doi: 10.5792/ksrr.2014.26.1.27. Epub 2014 Feb 27.

Abstract

PURPOSE

To evaluate the outcomes of the treatment of distal femoral fractures using minimally invasive plate osteosynthesis following total knee arthroplasty (TKA).

MATERIALS AND METHODS

From July 2008 to October 2011, 14 patients were treated with minimally invasive plate osteosynthesis for periprosthetic fractures following TKA. The mean duration of follow-up was 19.2 months and the mean age was 69.7 years. Lewis and Rorabeck classification was used to categorize the type of fracture. Pre- and postoperative range of motion, femorotibial angle, and Knee society score, time to bony union, and complications were evaluated.

RESULTS

The mean range of motion was 108.4 degrees preoperatively and 107.3 degrees postoperatively. No significant difference was observed in the pre- and postoperative mean range of motion. The average time to bony union was 3.9 months. The knee society score was 82.6 points preoperatively and 78.9 points postoperatively. The mean femorotibial angle was changed from 6.1 degrees valgus postoperatively to 4.6 degrees valgus postoperatively. There was no complication during the follow-up.

CONCLUSIONS

Minimally invasive plate fixation for distal femur fractures after TKA showed good results. Minimally invasive plate osteosynthesis is a recommendable treatment method for periprosthetic fractures.

摘要

目的

评估全膝关节置换术(TKA)后采用微创钢板接骨术治疗股骨远端骨折的疗效。

材料与方法

2008年7月至2011年10月,14例患者在TKA后因假体周围骨折接受微创钢板接骨术治疗。平均随访时间为19.2个月,平均年龄为69.7岁。采用Lewis和Rorabeck分类法对骨折类型进行分类。评估术前和术后的活动范围、股胫角、膝关节协会评分、骨愈合时间及并发症。

结果

术前平均活动范围为108.4度,术后为107.3度。术前和术后平均活动范围未见显著差异。平均骨愈合时间为3.9个月。膝关节协会评分术前为82.6分,术后为78.9分。平均股胫角从术后外翻6.1度变为术后外翻4.6度。随访期间无并发症发生。

结论

TKA后股骨远端骨折的微创钢板固定显示出良好的效果。微创钢板接骨术是治疗假体周围骨折的一种推荐治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/702e/3953522/96ceb7872db8/ksrr-26-27-g001.jpg

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