Nauth Aaron, Nousiainen Markku T, Jenkinson Richard, Hall Jeremy
Assistant Professor, Department of Surgery, Division of Orthopaedics, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
Instr Course Lect. 2015;64:161-73.
The management of periprosthetic fractures is an issue of increasing importance for orthopaedic surgeons. Because of the expanding indications for total joint arthroplasty (TJA) and an aging population with increasingly active lifestyles, the incidence of primary and revision TJA is increasing, and there is a corresponding increase in the prevalence of periprosthetic fractures about a TJA. The management of these fractures is often complex because of issues with obtaining fixation around implants, dealing with osteopenic bone or compromised bone stock, and the potential need for revising loose TJA components. In addition, these injuries frequently occur in frail, elderly patients, and the literature has demonstrated that both morbidity and mortality in these patients is similar to that of the geriatric hip fracture population. As such, the early restoration of function and ambulation is critical in patients with these injuries, and effective surgical strategies to achieve these goals are essential.
对于骨科医生而言，假体周围骨折的处理是一个日益重要的问题。由于全关节置换术（TJA）的适应证不断扩大，以及人口老龄化导致生活方式日益活跃，初次和翻修TJA的发生率正在增加，TJA周围假体周围骨折的患病率也相应上升。由于在植入物周围获得固定、处理骨质疏松骨或骨量受损以及可能需要翻修松动的TJA组件等问题，这些骨折的处理通常很复杂。此外，这些损伤经常发生在体弱的老年患者中，文献表明这些患者的发病率和死亡率与老年髋部骨折人群相似。因此，对于这些损伤的患者，早期恢复功能和行走能力至关重要，实现这些目标的有效手术策略必不可少。
