Çiçek Hakan, Tuhanioğlu Ümit, Oğur Hasan Ulaş, Seyfettinoğlu Fırat, Bozkurt Murat
Adana Numune Training and Research Hospital, Orthopedics and Traumatology Department, Adana, Turkey.
Adana Numune Training and Research Hospital, Orthopedics and Traumatology Department, Adana, Turkey.
Acta Orthop Traumatol Turc. 2018 Mar;52(2):92-96. doi: 10.1016/j.aott.2017.09.010. Epub 2018 Jan 3.
Patients with Su Type III fractures based on total knee arthroplasty (TKA) constitute a patient group with problematic treatment and management. Although it has difficulties, open reduction and internal fixation is one of the treatment options.
A retrospective evaluation was made of 22 patients surgically treated in our clinic with double locking, low contact titanium plate and screw for a Su Type III periprosthetic fracture based on TKA. The patients were evaluated with bone mineral densitometry, postoperative Knee Society Score (KSS), WOMAC and radiological evaluations.
The mean follow-up period of the patients was 68.6 ± 15.5 months, with pain-free weight-bearing determined at 4.9 ± 1.1 months and mean radiological union at 18.5 ± 4.3 weeks. Revision was required because of non-union in 2 (9.09%) cases. The postoperative KSS value was 81.8 ± 7.8, the WOMAC value was 78.1 ± 5.3 and the T-score was -3.3 ± 0.3. At the final follow-up examination, a correction loss (4.9° ± 1.5°) was determined in the mean knee valgus angle according to the mechanical axis, which was statistically significant but remained within the physiological limits (p = 0.21).
In addition to providing the advantages of rigid fixation together with early and effective rehabilitation, satisfactory clinical and radiological results were obtained with the application of double locking plate and screw in the treatment of periprosthetic femoral fractures based on TKA, with osteoporosis.
Level IV, Therapeutic study.
基于全膝关节置换术（TKA）的苏Ⅲ型骨折患者是治疗和管理存在问题的患者群体。尽管存在困难，但切开复位内固定仍是治疗选择之一。
对在我们诊所接受手术治疗的22例基于TKA的苏Ⅲ型假体周围骨折患者进行回顾性评估，采用双锁定、低接触钛板和螺钉固定。对患者进行骨密度测定、术后膝关节协会评分（KSS）、WOMAC评分及影像学评估。
患者平均随访时间为68.6±15.5个月，无痛负重确定为4.9±1.1个月，平均影像学愈合时间为18.5±4.3周。2例（9.09%）因骨不连需要翻修。术后KSS评分为81.8±7.8，WOMAC评分为78.1±5.3，T值为-3.3±0.3。在末次随访检查时，根据机械轴测量平均膝外翻角度有4.9°±1.5°的矫正丢失，具有统计学意义，但仍在生理范围内（p=0.21）。
双锁定钢板和螺钉应用于治疗基于TKA且伴有骨质疏松的假体周围股骨骨折，除了具有坚强固定以及早期有效康复的优点外，还获得了满意的临床和影像学结果。
IV级，治疗性研究。
