Trieb K, Fialka C
Abteilung für Orthopädie, Klinikum Wels-Grieskirchen, Wels, Österreich.
Abteilung für Unfallchirurgie, AUVA Unfallkrankenhaus Meidling, Wien, Österreich.
Z Orthop Unfall. 2016 Dec;154(6):639-653. doi: 10.1055/s-0042-116782. Epub 2016 Dec 14.
Periprosthetic femoral fractures can be categorized into proximal fractures around a hip stem or distally around a knee arthroplasty. This paper focuses on the proximal periprosthetic fractures. It is important to classify the fracture at diagnosis and to perform accurate planning of the surgery. Basically it is necessary to decide if the implant is fixed or loose, in the latter case a revision surgery including the change of the endoprosthesis is neccessary. If the implant is fixed an open reduction and internal fixation can be done. All implants have to be available on site because in the course of the intervention the plan could change. Due to rising numbers of primary arthroplasties and more elderly patients an increase of periprosthetic fractures can be expected. The treatment of periprosthetic fractures is an economic and surgical challenge. It is important to provide competence for these cases concerning both operative techniques and interdisciplinary treatment.
假体周围股骨骨折可分为围绕髋关节柄的近端骨折或围绕膝关节置换术的远端骨折。本文重点关注近端假体周围骨折。在诊断时对骨折进行分类并准确规划手术非常重要。基本上,有必要确定植入物是固定的还是松动的,在后一种情况下,需要进行包括更换假体在内的翻修手术。如果植入物是固定的,可以进行切开复位内固定。所有植入物都必须在现场可用,因为在手术过程中计划可能会改变。由于初次关节置换术数量的增加以及老年患者的增多,预计假体周围骨折的数量会增加。假体周围骨折的治疗是一项经济和手术挑战。在手术技术和多学科治疗方面为这些病例提供专业能力非常重要。