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[锁定钢板联合异种骨板治疗温哥华B1型人工关节周围股骨骨折]

[Treatment of Vancouver type B1 periprosthetic femoral fracture with locked plate and xenogenic bony plate].

作者信息

Chen Qi, Chen Wei, Ding Zhen-Qi, Liu Guo-Jun, Gao Jian-Ting, Liu Yan

机构信息

The Center of Orthopaedics and Traumatology of PLA of 175th Hospital, Zhangzhou 363000, Fujian, China.

The Center of Orthopaedics and Traumatology of PLA of 175th Hospital, Zhangzhou 363000, Fujian, China; gkxiaohe@ 163.com.

出版信息

Zhongguo Gu Shang. 2016 Aug 25;29(8):734-737. doi: 10.3969/j.issn.1003-0034.2016.08.012.

Abstract

OBJECTIVE

To analyze the therapeutic effect of plate cable system and cortical strut bone graft in the prosthesis revision of the total hip arthroplasty for the treatment of Vancouver type B1 periprosthetic femoral fracture.

METHODS

A total of 8 patients were selected from January 2006 to January 2013, including 6 males and 2 females, aged from 56 to 74 years old (62.52 years old on average). All the cases were treated by the long plate cable system and appropriate cortical strut bone graft. Harris score was used to evaluate the hip functions before and after the operation. Prosthesis stability and the bony union were assessed by the digital radiography.

RESULTS

All the patients were followed up for 45 months on average ranging from 24 to 60 months after operation. All the fractures reached union, and there was no infection, stem loosening, nonunion and malunion. The Harris score was 28.45±5.78 before operation, which was improved to 83.46±10.21 after operation. X ray showed that the prosthesis was stable, and the host bone and bone graft achieved bony union in 7 patients;and the other 1 patient need further operation of revision around the loose stem.

CONCLUSIONS

The prosthesis revision of the total hip arthroplasty with the locking plate and cortical strut bone graft used for the Vancouver type B1 periprosthetic proximal femur fractures has the advantages of simple manipulation, less complications, good recovery of the hip function and can improve bone quality to provide favorable conditions for operation of revision.

摘要

目的

分析钢板缆索系统联合皮质支撑骨移植在全髋关节置换翻修术中治疗温哥华B1型股骨假体周围骨折的疗效。

方法

选取2006年1月至2013年1月期间的8例患者,其中男性6例,女性2例,年龄56至74岁(平均62.52岁)。所有病例均采用长钢板缆索系统及适当的皮质支撑骨移植治疗。采用Harris评分评估手术前后髋关节功能。通过数字X线摄影评估假体稳定性及骨愈合情况。

结果

所有患者术后平均随访45个月,随访时间24至60个月。所有骨折均达到愈合,无感染、假体柄松动、骨不连及畸形愈合。术前Harris评分为28.45±5.78,术后提高至83.46±10.21。X线显示假体稳定,7例患者宿主骨与移植骨达到骨愈合;另1例患者需要围绕松动的假体柄进一步行翻修手术。

结论

锁定钢板联合皮质支撑骨移植用于全髋关节置换翻修术治疗温哥华B1型股骨近端假体周围骨折,具有操作简单、并发症少、髋关节功能恢复良好的优点,且能改善骨质,为翻修手术提供有利条件。

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