Jantsch S, Leixnering M, Schwägerl W, Hackl H
Orthopädische Abteilung, Pulmologisches Zentrum, Vienna.
Arch Orthop Trauma Surg (1978). 1988;107(4):236-41. doi: 10.1007/BF00449676.
Since 1982, at the Orthopedic Department of the Pulmologic Center of the City of Vienna we have used the Zweymüller shaft system and the pyramidal threaded socket by Schwägerl when implanting cementless hip endoprostheses. Some patients repeatedly complained about pains in the shaft region within the first postoperative months, though these complaints could not be explained clinically or radiographically. On 15 human cadavers we implanted a total of 20 Zweymüller shafts and examined the femurs for ruptures of the shaft. Our special interest was the course of the fracture lines, their localization, and their display on roentgenograms. It appeared that fissures of the shaft are easily caused by the forced driving-in of the prosthesis. In about half of all cases the fissure cannot be seen on roentgenograms because of the site is covered by the implant itself. The fracture lines do not always begin intertrochanterally or from the calcar femoris; therefore, they cannot be recognized during surgery. This problem should be considered during implantation as well as during postoperative remobilization.
自1982年以来，在维也纳市肺病中心骨科，我们在植入非骨水泥型髋关节假体时使用了Zweymüller股骨干系统和Schwägerl锥形螺纹髋臼杯。一些患者在术后最初几个月反复抱怨股骨干区域疼痛，尽管这些症状在临床或影像学上均无法解释。我们在15具人体尸体上共植入了20根Zweymüller股骨干，并检查股骨是否有股骨干断裂。我们特别关注骨折线的走向、位置及其在X线片上的显示情况。结果发现，假体强行打入很容易导致股骨干出现裂缝。在所有病例中，约有一半由于裂缝部位被植入物本身覆盖，在X线片上看不到裂缝。骨折线并非总是始于转子间或股骨距；因此，在手术过程中无法识别。在植入过程以及术后康复过程中都应考虑到这个问题。
