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不稳定型股骨近端骨折采用股骨近端锁定加压钢板治疗后的并发症:中期随访

Complications following proximal femoral locking compression plating in unstable proximal femur fractures: medium-term follow-up.

作者信息

Hodel Sandro, Beeres Frank J P, Babst Reto, Link Björn-Christian

机构信息

Department of Orthopaedic and Trauma Surgery, Luzerner Kantonsspital, 6000, Luzern 16, Switzerland.

出版信息

Eur J Orthop Surg Traumatol. 2017 Dec;27(8):1117-1124. doi: 10.1007/s00590-017-1981-1. Epub 2017 May 25.

Abstract

PURPOSE

To assess the outcome in patients treated with proximal femoral locking compression plate (PF-LCP 4.5/5.0, Synthes) for unstable inter- and subtrochanteric femoral fractures.

METHODS

A retrospective analysis of 16 patients with proximal femur fractures (AO: 31A2: n = 5/32.3%; 31-A3: n = 10/62.5%; 32B1: n = 1/6.3%) treated with a PF-LCP at a Level 1 trauma centre between 2011 and 2015 was conducted.

RESULTS

Sixteen patients were available for follow-up with a mean follow-up time of 14 months (range 4-29). Primary outcome included fracture healing, post-operative complications and post-operative ambulatory status. Male to female ratio was 1:1. Mean age was 61 ± 17 years. Union was achieved in a mean of 13.5 ± 3 weeks (range 12-20 weeks). Five patients (31.3%) had implant-associated complications like non-union, malrotation, late implant-associated infection, distal screw fractures and post-traumatic impingement of the hip. Consequently, four patients (25%) had to undergo revision surgery. There was no reported case of secondary varus collapse or cut-out.

CONCLUSIONS

Complications occurred in 31.3% (n = 5) in medium-term follow-up after PF-LCP in proximal unstable inter- and subtrochanteric femur fractures. These findings are supported by results of other groups. However, further studies to evaluate risk factors associated with failure of this implant are required.

摘要

目的

评估采用股骨近端锁定加压钢板(PF-LCP 4.5/5.0,辛迪思公司)治疗不稳定型股骨转子间及转子下骨折患者的治疗结果。

方法

对2011年至2015年期间在某一级创伤中心接受PF-LCP治疗的16例股骨近端骨折患者(AO分型:31A2型:n = 5/32.3%;31-A3型:n = 10/62.5%;32B1型:n = 1/6.3%)进行回顾性分析。

结果

16例患者均获得随访,平均随访时间为14个月(4 - 29个月)。主要观察指标包括骨折愈合情况、术后并发症及术后活动状态。男女比例为1:1。平均年龄为61±17岁。骨折平均在13.5±3周(12 - 20周)愈合。5例患者(31.3%)出现与植入物相关的并发症,如骨不连、畸形旋转、晚期植入物相关感染、远端螺钉骨折及创伤后髋关节撞击。因此,4例患者(25%)不得不接受翻修手术。未报告继发性内翻塌陷或内固定物穿出的病例。

结论

在不稳定型股骨转子间及转子下骨折患者中,采用PF-LCP治疗的中期随访结果显示,并发症发生率为31.3%(n = 5)。其他研究组的结果也支持这些发现。然而,需要进一步研究以评估与该植入物失败相关的危险因素。

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