Speranza Attilio, Massafra Carlo, Pecchia Stefano, Di Niccolo Riccardo, Iorio Raffaele, Ferretti Andrea
Orthopaedic and Traumatology Unit, Sant' Andrea Hospital, "Sapienza" University of Rome, 00189 Rome, Italy.
J Clin Med. 2022 Mar 14;11(6):1608. doi: 10.3390/jcm11061608.
Metallic cerclage cables are reliable and cost-effective internal fixation devices, which are largely used in surgical practice for the treatment of periprosthetic fractures. Nevertheless, complications connected with their use have been described in the literature, including the following: third-body generation, failure and consequent migration, fraying, allergies, and injury to the surgical team. The development of new materials offers alternatives to traditional metallic cables. This study compares the outcomes between two groups of patients affected by periprosthetic hip fractures, treated with titanium cables or with ultra-high-molecular-weight polyethylene (UHMWPe) iso-elastic cables. Our retrospective study aims to compare the clinical and radiological outcomes of titanium cables and UHMWPe iso-elastic cables, isolated or associated with dedicated plates, for the surgical treatment of periprosthetic fractures with stable implants. Two groups of 30 (group A-metallic cables) and 24 (group B-UHMWPe iso-elastic cables) patients have been surgically treated in our institution for hip periprosthetic fractures, between September 2017 and June 2020. The mean age of the patients was 81 years in group A and 80 years in group B. In our study, we included fractures classified as B1 or C, according to the Vancouver postoperative fractures classification; the patients were evaluated retrospectively at 1 year postoperatively, regarding the following: surgery time, blood loss, partial weight-bearing time, radiographical healing time, Harris hip score, and postoperative complications. Comparable outcomes were observed in patients from both groups. Group A showed a higher complication rate compared to group B, at 1 year postoperatively. Non-metallic nylon fiber and ultra-high-molecular-weight polyethylene (UHMWPe) cerclage cables could represent a reliable fixation device, ensuring comparable healing and complication rates with traditional titanium cerclage cables.
金属环扎缆线是可靠且经济高效的内固定装置，在外科手术中广泛用于治疗假体周围骨折。然而，文献中已描述了与使用它们相关的并发症，包括以下几种：第三体生成、失效及随之而来的移位、磨损、过敏以及对外科手术团队的损伤。新材料的开发为传统金属缆线提供了替代方案。本研究比较了两组假体周围髋关节骨折患者的治疗结果，一组用钛缆线治疗，另一组用超高分子量聚乙烯（UHMWPe）等弹性缆线治疗。我们的回顾性研究旨在比较钛缆线和UHMWPe等弹性缆线（单独使用或与专用钢板联合使用）用于稳定植入物的假体周围骨折手术治疗的临床和放射学结果。2017年9月至2020年6月期间，我们机构对两组患者进行了髋关节假体周围骨折的手术治疗，一组30例（A组 - 金属缆线），另一组24例（B组 - UHMWPe等弹性缆线）。A组患者的平均年龄为81岁，B组为80岁。在我们的研究中，根据温哥华术后骨折分类，纳入了分类为B1或C型的骨折；对患者进行术后1年的回顾性评估，评估内容包括：手术时间、失血量、部分负重时间、放射学愈合时间、Harris髋关节评分以及术后并发症。两组患者观察到了可比的结果。术后1年时，A组的并发症发生率高于B组。非金属尼龙纤维和超高分子量聚乙烯（UHMWPe）环扎缆线可能是一种可靠的固定装置，能确保与传统钛环扎缆线具有可比的愈合率和并发症发生率。
