Keppler A M, Zeckey C, Kammerlander C, Böcker W, Neuerburg C
Klinik für Allgemeine, Unfall- und Wiederherstellungschirurgie, Campus Innenstadt und Großhadern, Klinikum der Universität München, Nußbaumstraße 20, 80336, München, Deutschland.
Unfallchirurg. 2018 Dec;121(12):999-1003. doi: 10.1007/s00113-018-0530-7.
This article presents the case of an 83-year-old woman with a peri-implant femoral fracture after hip arthrodesis in adolescence. Due to the rarity of such operations, there is no standardized approach for these cases. In order to secure the treatment goal of rapid pain-adapted full weight bearing despite reduced bone quality, it was decided to perform a new osteosynthesis with a retrograde femoral nail after removal of some fixation screws of the existing arthrodesis plate. Due to this type of treatment, the preservation of activity and independence of an older trauma patient could be sustainably secured despite operative challenges. Taking an extended osteoporosis treatment into consideration, a bony fracture consolidation and complete convalescence of activity and autonomy were ultimately achieved.
本文介绍了一名83岁女性的病例,该患者在青春期接受髋关节融合术后发生了股骨假体周围骨折。由于此类手术罕见,目前尚无针对这些病例的标准化治疗方法。为了实现尽管骨质下降仍能快速适应疼痛并完全负重的治疗目标,决定在拆除现有融合钢板的一些固定螺钉后,使用逆行股骨钉进行新的骨固定术。由于采用了这种治疗方式,尽管手术面临挑战,但仍可持续确保老年创伤患者的活动能力和独立性。考虑到进行长期骨质疏松治疗,最终实现了骨折愈合以及活动和自主能力的完全康复。