Cheng Qi, Zhao Fengchao, Guo Kaijin, Zha Guochun, Zheng Xin, Pang Yong
Department of Orthopaedics, the Affiliated Hospital of Xuzhou Medical University, Xuzhou Jiangsu, 221006, P.R.China.
Department of Orthopaedics, the Affiliated Hospital of Xuzhou Medical University, Xuzhou Jiangsu, 221006,
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2017 Nov 15;31(11):1291-1294. doi: 10.7507/1002-1892.201704133.
To evaluate the mid-term effectiveness of cerclage wires fixation in treating Mallory typeⅡperiprosthetic femoral fractures associated with primary hip arthroplasty.
A retrospective analysis was made in the data of 14 patients (14 hips) with Mallory typeⅡ periprosthetic femoral fractures associated with primary hip arthroplasty and treated with cerclage wires fixation between January 2010 and June 2011 (fracture group). Twenty-eight patients (28 hips) without periprosthetic femoral fractures associated with primary hip arthroplasty at the same stage were chosen as control group. The uncemented femoral prosthesis were used in 2 groups. There was no significant difference in gender, age, body mass index, and primary disease between 2 groups ( >0.05). The operation time, intraoperative blood loss, and the complications were recorded. The Harris score was used to evaluate the hip function and the visual analogue scale (VAS) score was used to evaluate the pain degree of hip. According to the postoperative X-ray films of hips, Engh standard was used to evaluate the fixed and stable status of the femoral prosthesis; the heterotopic ossification was observed; the time of fracture union was recorded.
The operation time of fracture group was significantly longer than that of control group ( =-3.590， =0.001). There was no significant difference in the intraoperative blood loss between 2 groups ( =-1.276, =0.209). All patients were followed up 64-75 months (mean, 69.5 months). Hip dislocation after operation occurred in 1 case of fracture group; delirium symptom and nonunion of incision occurred in 1 case and 1 case of control group, respectively. There was no significant difference in the Harris score and VAS score at 6 months and 5 years between 2 groups ( >0.05). X-ray films showed that all fractures healed and the mean time of fracture union were 6.1 months (range, 3-12 months). There was no fracture nonunion or malunion evidently. There was no significant difference in X-ray score at 6 months and 5 years between 2 groups ( >0.05). At last follow-up, cerclage wires displacement or breakage did not occur. Heterotopic ossification occurred in 2 cases of fracture group and in 1 case of control group.
Cerclage wires fixation can achieve the good mid-term effectiveness in treating Mallory typeⅡintraoprative periprosthetic femoral fractures associated with primary hip arthroplasty.
评估环扎钢丝固定治疗与初次髋关节置换相关的马洛里Ⅱ型假体周围股骨骨折的中期疗效。
回顾性分析2010年1月至2011年6月间14例（14髋）与初次髋关节置换相关的马洛里Ⅱ型假体周围股骨骨折并采用环扎钢丝固定治疗的患者（骨折组）的数据。选取同期28例（28髋）无初次髋关节置换相关假体周围股骨骨折的患者作为对照组。两组均采用非骨水泥型股骨假体。两组在性别、年龄、体重指数及原发疾病方面差异无统计学意义（P>0.05）。记录手术时间、术中出血量及并发症情况。采用Harris评分评估髋关节功能，采用视觉模拟评分（VAS）评估髋关节疼痛程度。根据术后髋关节X线片，采用Engh标准评估股骨假体的固定及稳定情况；观察异位骨化情况；记录骨折愈合时间。
骨折组手术时间显著长于对照组（t=-3.590，P=0.001）。两组术中出血量差异无统计学意义（t=-1.276，P=0.209）。所有患者均随访64-75个月（平均69.5个月）。骨折组术后发生髋关节脱位1例；对照组分别发生谵妄症状及切口不愈合各1例。两组在术后6个月及5年时的Harris评分和VAS评分差异无统计学意义（P>0.05）。X线片显示所有骨折均愈合，骨折愈合平均时间为6.1个月（范围3-12个月）。无明显骨折不愈合或畸形愈合。两组在术后6个月及5年时的X线评分差异无统计学意义（P>0.05）。末次随访时，未发生环扎钢丝移位或断裂。骨折组发生异位骨化2例，对照组发生1例。
环扎钢丝固定治疗与初次髋关节置换相关的马洛里Ⅱ型术中假体周围股骨骨折可取得良好的中期疗效。
