Refaat Motasem, Coleman Sheldon, Meehan John P, Jamali Amir A
Department of Orthopaedic Surgery, University of California Davis, Sacramento, CA.
Am J Orthop (Belle Mead NJ). 2015 Feb;44(2):90-3.
Periprosthetic supracondylar fractures of the femur after total knee arthroplasty represent a devastating complication for the patient and a technical challenge for the surgeon. Treatment is often complicated by advanced patient age, retained cement, and accompanying osteoporosis. We present the case of a 54-year-old woman with a comminuted fracture of the distal femur just above a total knee prosthesis. She had a complex past medical history, including extensive coronary artery disease, morbid obesity, chronic osteoporosis, anemia, diabetes, and rheumatoid arthritis. She was a Jehovah's Witness and thus refused all blood products. Given her medical history, religious preferences, and fracture comminution, a spanning external fixator was used. She completed fracture union with an excellent clinical and radiographic result at 2 years.
全膝关节置换术后股骨假体周围髁上骨折对患者来说是一种灾难性并发症，对外科医生而言是一项技术挑战。治疗常因患者高龄、存留骨水泥及合并骨质疏松而变得复杂。我们报告一例54岁女性患者，其股骨远端在全膝关节假体上方发生粉碎性骨折。她有复杂的既往病史，包括广泛冠状动脉疾病、病态肥胖、慢性骨质疏松、贫血、糖尿病和类风湿关节炎。她是一名耶和华见证会信徒，因此拒绝接受所有血液制品。鉴于她的病史、宗教信仰及骨折粉碎情况，采用了跨越性外固定架。她在2年后实现骨折愈合，临床和影像学结果均极佳。
