围绕羟基磷灰石涂层柄的不完整、类稳定型假体周围温哥华B型骨折。是否存在策略性谨慎忽视的情况？

Incomplete, stable-like, peri-prosthetic Vancouver B fracture around an ha-coated stem. Is there a case for strategic thoughtful neglect?

作者信息

Spina Mauro, Scalvi Andrea, Vacchiano Andrea, Sandri Andrea, Balsano Massimo

机构信息

Azienda Ospedaliera Universitaria Integrata of Verona, Department of Orthopedics and Traumatology A, Piazzale A. Stefani n.1, 37126, Verona, Italy.

Ospedale di Cittadella ULSS 6 Euganea, Director of Department of Orthopedics and Traumatology, Via Casa di Ricovero, 40, 35013, Cittadella, PD, Italy.

出版信息

Trauma Case Rep. 2019 Nov 27;24:100252. doi: 10.1016/j.tcr.2019.100252. eCollection 2019 Dec.

DOI:10.1016/j.tcr.2019.100252

PMID:31832533

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6890950/

Abstract

The Periprosthetic fracture of the proximal femur is usually treated by internal fixation of the fracture or revision of the femoral stem depending on the characteristics of the fracture and stability of the implant. This case report shows an early periprosthetic fracture around an uncemented straight stem which is treated conservatively with an excellent clinical radiographic result and explains the biomechanics related to this non-operative choice. A conservative treatment of periprosthetic fracture is possible but only after a careful analysis of the fracture pattern, the characteristics of the prosthetic stem and the time elapsed from implanting the prosthesis to the fracture.

摘要

股骨近端假体周围骨折通常根据骨折特点和植入物稳定性，采用骨折内固定或股骨柄翻修术进行治疗。本病例报告展示了一例围绕非骨水泥直柄假体的早期假体周围骨折，采用保守治疗取得了优异的临床影像学结果，并解释了与这种非手术选择相关的生物力学原理。假体周围骨折的保守治疗是可行的，但前提是要仔细分析骨折类型、假体柄的特点以及从假体植入到骨折发生所经过的时间。