Füchtmeier Bernd, Doblinger Matthias, Müller Franz
Clinic for Trauma, Orthopaedic and Sports Medicine, Hospital Barmherzige Brüder, Prüfeninger Str. 86, 93049, Regensburg, Germany.
Int Orthop. 2020 Jul;44(7):1391-1399. doi: 10.1007/s00264-020-04561-6. Epub 2020 Apr 16.
The aim of this study was to assess patients treated for interprosthetic femoral fractures (IFFs).
Based on our database, we performed a retrospective single-center analysis of patients who underwent surgery for the treatment of IFFs. We evaluated patient demographics, fracture patterns, type of surgery, revision, and mortality for a minimum of one year after treatment. Outcomes were assessed via telephone using the Parker score.
Fifty consecutive patients were enrolled. An analysis of fracture patterns revealed three different types: proximal (n = 19), intermediate (n = 13), and distal (n = 18). Treatment included internal fixation for stable components and revision arthroplasty for loose implants; and a lateral locking plate was the most commonly applied device. The mean follow-up time of the total sample was 5.7 years after the operation. The total revision rate was 22%, and the highest revision rate was documented for revision arthroplasty. The one year mortality rate for the sample was 14%, and fracture patterns and treatment revealed no effects on mortality. Living patients (n = 23) were followed up for an average of 4.9 years after treatment. Only six patients reported the best Parker score (mean, 5.0; range 0-9).
IFFs can be divided into three groups irrespective of the type of stem or bone quality, but fixation (stable or loose) must also be considered to determine the treatment. Fracture patterns and treatment revealed no effects on mortality. There are many treatment options but no single solution for IFFs.
本研究旨在评估接受人工关节周围股骨骨折（IFFs）治疗的患者。
基于我们的数据库，我们对接受手术治疗IFFs的患者进行了回顾性单中心分析。我们评估了患者的人口统计学特征、骨折类型、手术方式、翻修情况以及治疗后至少一年的死亡率。通过电话使用帕克评分评估结果。
连续纳入50例患者。对骨折类型的分析显示有三种不同类型：近端（n = 19）、中间（n = 13）和远端（n = 18）。治疗包括对稳定部件进行内固定以及对松动植入物进行翻修关节成形术；外侧锁定钢板是最常用的器械。整个样本的平均随访时间为术后5.7年。总翻修率为22%，翻修关节成形术的翻修率最高。样本的一年死亡率为14%，骨折类型和治疗对死亡率无影响。存活患者（n = 23）治疗后平均随访4.9年。只有6例患者报告帕克评分最佳（平均5.0；范围0 - 9）。
无论柄的类型或骨质如何，IFFs可分为三组，但在确定治疗方案时还必须考虑固定情况（稳定或松动）。骨折类型和治疗对死亡率无影响。对于IFFs有多种治疗选择，但没有单一的解决方案。
