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采用取出内植物、应用股骨远端加长锁定钢板及植骨治疗股骨近端短髓内钉周围股骨干骨折——1例报告

Management of Short Proximal Femur Nail Peri-Implant Fracture of Femur Shaft with Implant Removal and Long Distal Femur Locking Plate and Bone Grafting - A Case Report.

作者信息

Mahajan Neetin P, Ghoti Santosh, Patil Tushar C, Pande Kartik P, Talukder Pritam

机构信息

Department of Orthopaedics, Grant Government Medical College, Mumbai, Maharashtra, India.

出版信息

J Orthop Case Rep. 2022 Feb;12(2):65-68. doi: 10.13107/jocr.2022.v12.i02.2670.

Abstract

INTRODUCTION

The rising demographic trend towards elderly population and increased incidence of osteosynthesis of proximal femur fractures are associated with increased recurrent falls and rise in incidence of peri- implant fractures.

CASE REPORT

Here, we present a difficult case of a peri-implant femur shaft fracture in a 55-year-old male, with stuck short proximal femur nail (PFN) removal followed by long distal femur plating with bone grafting showing good fracture union at 1 year with satisfactory functional outcome.

CONCLUSION

Peri- implant femur fractures are quite rare and more commonly occur in elderly. Among all treatment modalities for intertrochanteric femur fracture fixation, the literature shows short PFN having highest comparative risk for peri-implant fractures. Implant removal followed by locking plates for long spiral fractures provides a stable, anatomical, and reliable fixation. Bone grafting augments bony union, especially in cases of bone defects .

摘要

引言

人口老龄化趋势加剧以及股骨近端骨折内固定术的发病率上升,与反复跌倒的增加以及植入物周围骨折的发病率上升有关。

病例报告

在此,我们展示了一例55岁男性植入物周围股骨干骨折的疑难病例,取出卡住的股骨近端短钉(PFN),随后进行股骨远端长钢板内固定并植骨,1年后骨折顺利愈合,功能结果令人满意。

结论

植入物周围股骨骨折相当罕见,且更常见于老年人。在所有股骨转子间骨折固定的治疗方式中,文献表明股骨近端短钉发生植入物周围骨折的相对风险最高。对于长螺旋骨折,取出植入物后使用锁定钢板可提供稳定、解剖学和可靠的固定。植骨可促进骨愈合,尤其是在存在骨缺损的情况下。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06a5/9499139/ec13fc45af1c/JOCR-12-65-g001.jpg

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