一例患者双侧解剖型髓内锁定髋关节置换柄骨折：病例报告
Bilateral Fractures of Anatomic Medullary Locking Hip Arthroplasty Stems in a Single Patient: A Case Report.
作者信息
Slaven Sean E, Harrington Colin J, Cody John P
机构信息
Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
出版信息
J Orthop Case Rep. 2020;10(2):46-49. doi: 10.13107/jocr.2020.v10.i02.1690.
INTRODUCTION
Stem fracture is a rare complication of total hip arthroplasty (THA) using fully porous-coated femoral stems. Bilateral fractures in a single patient have not been previously reported.
CASE REPORT
A 48-year-old female underwent bilateral staged primary THA with fully porous-coated anatomic medullary locking femoral prostheses. She subsequently sustained stem fractures of her right and left prostheses in the 13thand 14thyears after their implantation, respectively.
CONCLUSION
The bilateral nature of this rare complication in a single patient supports the notion that stem fracture results from a mismatch between the mechanical stresses encountered in vivo and the structural properties of small-diameter stems. Surgeons should be cognizant of this potential complication when evaluating patients at long-term follow-up with new-onset pain.
引言
柄部骨折是使用全多孔涂层股骨柄进行全髋关节置换术（THA）的一种罕见并发症。此前尚未报道过单一患者发生双侧骨折的情况。
病例报告
一名48岁女性接受了双侧分期初次全髋关节置换术，使用的是全多孔涂层解剖型髓内锁定股骨假体。随后，她在植入假体后的第13年和第14年分别发生了右侧和左侧假体的柄部骨折。
结论
单一患者出现这种罕见并发症的双侧性支持了这样一种观点，即柄部骨折是由体内遇到的机械应力与小直径柄部的结构特性不匹配所致。在对长期随访中出现新发疼痛的患者进行评估时，外科医生应认识到这种潜在并发症。
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