Lichte Philipp, Kobbe Philipp, Pishnamaz Miguel, Hildebrand Frank
Klinik für Unfall- und Wiederherstellungschirurgie, Uniklinik RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.
Unfallchirurg. 2019 Nov;122(11):885-900. doi: 10.1007/s00113-019-00727-z.
The incidence of periprosthetic hip fractures is increasing due to the increase in endoprosthetic hip replacements. These fractures require a staged and individual treatment concept with the aim of mobilization of the patient as early as possible. The special challenge in the diagnostics is to identify pre-existing signs of loosening of the prosthesis. When the prosthesis is still firmly fixed femoral fractures can be treated with angular stable osteosynthesis. Loosened stems usually have to be revised, mostly in combination with osteosynthesis. Fractures around the acetabulum with a fixed cup can be treated nonoperatively or with osteosynthesis, while loosened cups have to be revised. In revision surgery the stabilization of the dorsal column is crucial for a successful outcome.
由于髋关节置换手术数量的增加,人工髋关节周围骨折的发生率正在上升。这些骨折需要一个分阶段的个体化治疗方案,目标是尽早使患者恢复活动能力。诊断中的特殊挑战在于识别假体松动的既有迹象。当假体仍牢固固定时,股骨骨折可采用角稳定接骨术治疗。松动的柄通常需要翻修,大多与接骨术联合进行。髋臼周围骨折且髋臼杯固定时,可采用非手术治疗或接骨术,而松动的髋臼杯则必须翻修。在翻修手术中,后柱的稳定对于取得成功的结果至关重要。