Nozaka Koji, Miyakoshi Naohisa, Sato Takeshi, Shimada Yoichi
Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
BMC Musculoskelet Disord. 2020 Mar 4;21(1):145. doi: 10.1186/s12891-020-3176-x.
The incidence of periprosthetic fractures after total knee arthroplasty (TKA) is rising due to the increasing number of TKAs performed annually and the growing elderly population. A periprosthetic fracture of the proximal tibia following TKA is a rare injury that may be a challenging clinical scenario.
The case of an 84-year-old woman who sustained a periprosthetic tibial fracture 10 years after a TKA is presented. This patient had multiple risk factors. The fracture was not deemed amenable to conventional treatment because the bone fragment was too small. This patient underwent fixation of her tibial fracture above the TKA using a five-ring Ilizarov external fixator. This allowed immediate full weight-bearing. The fixator was removed at 12 weeks, at which time the fracture was solidly healed. At the most recent follow-up, 2 years from injury, she was fully weight-bearing without walking aids and had a knee range of motion (ROM) of 0-110°.
To the best of our knowledge, this is the first report in which Ilizarov external fixation has been used for a periprosthetic tibial fracture after TKA.
由于每年全膝关节置换术（TKA）的实施数量不断增加以及老年人口的增长，TKA后假体周围骨折的发生率正在上升。TKA后胫骨近端假体周围骨折是一种罕见的损伤，可能是具有挑战性的临床情况。
本文介绍了一名84岁女性患者，在TKA术后10年发生假体周围胫骨骨折的病例。该患者存在多种危险因素。由于骨块过小，该骨折被认为不适合传统治疗。该患者使用五环伊里扎洛夫外固定器在TKA上方对胫骨骨折进行固定。这使得患者能够立即完全负重。外固定器在12周时拆除，此时骨折已牢固愈合。在受伤后2年的最近一次随访中，她无需辅助行走即可完全负重，膝关节活动范围（ROM）为0-110°。
据我们所知，这是首次报道伊里扎洛夫外固定用于TKA后假体周围胫骨骨折的病例。
