Department of Orthopaedics, University of Arizona, 1625 N Campbell Avenue, Tucson, AZ, 85719, USA.
Banner University Medical Group, Banner Health System Phoenix, Phoenix, AZ, USA.
Eur J Orthop Surg Traumatol. 2021 Jul;31(5):861-869. doi: 10.1007/s00590-021-02969-3. Epub 2021 Apr 14.
The incidence of periprosthetic fractures is expected to rise increase by 4.6% every 10 years between 2015 and 2060. There are few large series examining optimal fixation constructs or the influence of early ambulation on outcome. The purpose of this narrative review is to investigate the published biomechanical considerations for periprosthetic fracture fixation, with specific consideration of early postoperative weightbearing.
A literature review was performed to identify fracture incidences, etiology, and current trends in weightbearing after fixation. Benefits of early weightbearing, current constructs, and biomechanics are reviewed.
The limited data available support medical benefits and increased union rates with early mobilization. Optimal fixation constructs are not agreed upon, but mechanical studies suggest that dual implant constructs can support physiologic weightbearing loads.
Further clinical trials are required to investigate fracture union and hardware complications in dual implant construct.
预计在 2015 年至 2060 年期间，每 10 年假体周围骨折的发病率将增加 4.6%。很少有大型系列研究探讨最佳固定结构或早期活动对结果的影响。本叙述性综述的目的是研究假体周围骨折固定的已发表生物力学考虑因素，特别考虑术后早期负重。
进行了文献回顾，以确定骨折发生率、病因和固定后的当前负重趋势。回顾了早期负重的益处、当前的固定结构和生物力学。
有限的可用数据支持早期活动的医疗益处和增加的愈合率。尚未达成最佳固定结构的共识，但力学研究表明，双植入物结构可以支撑生理负重。
需要进一步的临床试验来研究双植入物结构中骨折愈合和硬件并发症。
