From the Department of Orthopaedic Surgery, the Warren Alpert Medical School of Brown University, Providence, RI.
J Am Acad Orthop Surg. 2018 Apr 15;26(8):e167-e172. doi: 10.5435/JAAOS-D-16-00387.
Periprosthetic fractures around total knee arthroplasty have become an increasingly common and challenging orthopaedic problem. Appropriate management of these fractures depends on careful scrutiny of radiographs and a thorough clinical history to exclude the diagnosis of a periprosthetic infection. In a periprosthetic tibial fracture with a stable, well-aligned tibial component and well-aligned mechanical tibial axis, the fracture can be successfully managed with closed reduction and cast immobilization; meticulous follow-up is essential to ensure that the alignment is maintained. Major fracture displacement, tibial component instability, and tibial component malalignment are all indications for surgical intervention. The ideal surgical intervention depends on the fracture characteristics and the stability and alignment of the tibial component.
人工膝关节置换术后的假体周围骨折已成为一个日益常见且具有挑战性的骨科问题。这些骨折的适当处理取决于仔细检查 X 光片和全面的临床病史，以排除假体周围感染的诊断。在具有稳定、对齐良好的胫骨组件和机械性胫骨轴对齐良好的假体周围胫骨骨折中，可以通过闭合复位和石膏固定成功治疗骨折；精细的随访至关重要，以确保保持对线。主要的骨折移位、胫骨组件不稳定和胫骨组件对线不良都是手术干预的指征。理想的手术干预取决于骨折的特征以及胫骨组件的稳定性和对线。
