Ragland Katelyn, Cherney Steven M, Stambough Jeffrey B, Mears Simon C
Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Geriatr Orthop Surg Rehabil. 2020 Jul 3;11:2151459320939547. doi: 10.1177/2151459320939547. eCollection 2020.
With the increase in knee and hip implants, these periprosthetic fractures will become more common especially as the population ages. Open periprosthetic fractures are rare and severe injuries and are more likely to be seen in high-energy injuries. They present challenges to the treating physician due to soft tissue damage, contamination of the existing implants, and the effects of polytrauma in the geriatric patient.
A 72-year-old woman was involved in a motor vehicle collision with multiple injuries including an open periprosthetic tibia and femur fracture. This was treated with initial washout and removal of loose tibial component with placement of a cement spacer. The knee was treated with staged revision using a protocol like that used after prosthetic joint infection. After complete soft tissue healing, the patient underwent successful revision with a megaprosthesis. The literature on open periprosthetic fractures is reviewed.
Open periprosthetic fractures present multiple challenges to the orthopedic surgeon. In the presences of poly trauma and soft tissue injury, we present an approach using staged surgery like that used for prosthetic joint infection.
随着膝关节和髋关节置换植入物的增加，尤其是随着人口老龄化，这些假体周围骨折将变得更加常见。开放性假体周围骨折较为罕见且伤势严重，更常见于高能量损伤。由于软组织损伤、现有植入物的污染以及老年患者多发伤的影响，它们给治疗医生带来了挑战。
病例回顾报告及文献综述结果：一名72岁女性遭遇机动车碰撞，多处受伤，包括开放性假体周围胫骨和股骨骨折。最初进行了清创冲洗，取出松动的胫骨部件并置入骨水泥间隔物。膝关节采用类似于假体关节感染后使用的方案进行分期翻修。在软组织完全愈合后，患者成功接受了大型假体翻修手术。对开放性假体周围骨折的文献进行了综述。
开放性假体周围骨折给骨科医生带来了多重挑战。在存在多发伤和软组织损伤的情况下，我们提出了一种采用类似于假体关节感染治疗的分期手术方法。
