柄部固定方法对温哥华B1型假体周围股骨骨折治疗的影响。
The impact of stem fixation method on Vancouver Type B1 periprosthetic femoral fracture management.
作者信息
Wang Katherine, Kenanidis Eustathios, Gamie Zakareya, Suleman Khurram, Miodownik Mark, Avadi Mahsa, Horne David, Thompson Jonathan, Tsiridis Eleftherios, Moazen Mehran
机构信息
Department of Mechanical Engineering, University College London, Torrington Place, London WC1E 7JE, UK.
Department of Mechanical Engineering, University College London, Torrington Place, London WC1E 7JE, UK - Academic Orthopaedics Department, Papageorgiou General Hospital & CORE Lab at CIRI AUTH, Aristotle University Medical School, University Campus 54 124, Thessaloniki, Greece.
出版信息
SICOT J. 2022;8:1. doi: 10.1051/sicotj/2021064. Epub 2022 Jan 6.
INTRODUCTION
Our understanding of the impact of the stem fixation method in total hip arthroplasty (THA) on the subsequent management of periprosthetic femoral fractures (PFF) is still limited. This study aimed to investigate and quantify the effect of the stem fixation method, i.e., cemented vs. uncemented THA, on the management of Vancouver Type B1 periprosthetic femoral fractures with the same plate.
METHODS
Eight laboratory models of synthetic femora were divided into two groups and implanted with either a cemented or uncemented hip prosthesis. The overall stiffness and strain distribution were measured under an anatomical one-legged stance. All eight specimens underwent an osteotomy to simulate Vancouver type B1 PFF's. Fractures were then fixed using the same extramedullary plate and screws. The same measurements and fracture movement were taken under the same loading conditions.
RESULTS
Highlighted that the uncemented THA and PFF fixation constructs had a lower overall stiffness. Subsequently, the mechanical strain on the fracture plate for the uncemented construct was higher compared to the cemented constructs.
CONCLUSION
PFF fixation of a Vancouver type B1 fracture using a plate may have a higher risk of failure in uncemented THAs.
引言
我们对全髋关节置换术（THA）中股骨柄固定方法对假体周围股骨骨折（PFF）后续处理的影响的理解仍然有限。本研究旨在调查并量化股骨柄固定方法，即骨水泥型与非骨水泥型THA，对使用相同钢板治疗温哥华B1型假体周围股骨骨折的影响。
方法
八个合成股骨的实验室模型分为两组，分别植入骨水泥型或非骨水泥型髋关节假体。在解剖学单腿站立状态下测量整体刚度和应变分布。所有八个标本均进行截骨以模拟温哥华B1型PFF。然后使用相同的髓外钢板和螺钉固定骨折。在相同加载条件下进行相同的测量和骨折移位测量。
结果
结果表明，非骨水泥型THA和PFF固定结构的整体刚度较低。随后，与骨水泥型结构相比，非骨水泥型结构的骨折钢板上的机械应变更高。
结论
使用钢板固定温哥华B1型骨折的PFF在非骨水泥型THA中可能具有更高的失败风险。
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