Li Yiyang, Chen Yang, Kong Ning, Tian Run, Wang Kunzheng, Yang Pei
Department of Bone and Joint Surgery, Xi'an Jiaotong University Second Affiliated Hospital, Xi'an Shaanxi, 710004, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2022 Oct 15;36(10):1244-1248. doi: 10.7507/1002-1892.202204128.
To analyze the effectiveness of shape memory alloy embracing device in the treatment of Vancouver B2 periprosthetic femoral fracture after primary hip arthroplasty.
The clinical data of 30 patients (30 hips) with Vancouver B2 periprosthetic femoral fracture after primary hip arthroplasty between January 2019 and January 2021 were analyzed retrospectively. Among them, 15 cases were treated with shape memory alloy embracing device for fracture fixation (group A) and 15 cases with titanium cable cerclage (group B). There was no significant difference in general data such as gender, age, body mass index, the cause of primary arthroplasty and surgical method, prosthesis type, the cause and side of femoral fracture, the time from injury to operation, and comorbidities between the two groups ( >0.05). The operation time, intraoperative blood loss, and hospital stay of the two groups were recorded. The fracture healing was examined by X-ray film, and the hip joint function was evaluated by Harris score.
The operations in both groups were completed successfully, and the incisions healed by first intention after operation with no vascular or nerve injury. The operation time and hospital stay in group A were significantly shorter than those in group B ( <0.05), but there was no significant difference in intraoperative blood loss between group A and group B ( =-0.518， =0.609). Patients were followed up 12-20 months (mean, 16.3 months) in group A and 12-22 months (mean, 16.7 months) in group B. X-ray film showed that all fractures healed, the healing time was (14.73±2.05) weeks in group A and (17.27±2.60) weeks in group B, and there was a significant difference between the two groups ( =-2.960， =0.006). During follow-up, there was no complication such as prosthesis loosening, periprosthetic infection, joint stiffness, or internal fixator loosening. The Harris score of group A was significantly better than that of group B at 3, 6, and 12 months after operation ( <0.05).
Compared with titanium cable cerclage, using shape memory alloy embracing device to fix Vancouver B2 periprosthetic femoral fracture can accelerate fracture healing, shorten operation time, and reduce intraoperative blood loss. Patients can perform functional exercise earlier and restore joint function better.
分析形状记忆合金环抱器治疗初次髋关节置换术后温哥华B2型股骨假体周围骨折的有效性。
回顾性分析2019年1月至2021年1月期间30例初次髋关节置换术后发生温哥华B2型股骨假体周围骨折患者（30髋）的临床资料。其中，15例采用形状记忆合金环抱器固定骨折（A组），15例采用钛缆环扎术（B组）。两组患者在性别、年龄、体重指数、初次置换的病因及手术方式、假体类型、股骨骨折的病因及部位、受伤至手术时间、合并症等一般资料方面比较，差异均无统计学意义（>0.05）。记录两组患者的手术时间、术中出血量及住院时间。通过X线片检查骨折愈合情况，采用Harris评分评估髋关节功能。
两组手术均顺利完成，术后切口均一期愈合，无血管、神经损伤。A组手术时间及住院时间均明显短于B组（<0.05），但A组与B组术中出血量比较，差异无统计学意义（=-0.518，=0.609）。A组患者随访1220个月（平均16.3个月），B组患者随访1222个月（平均16.7个月）。X线片显示所有骨折均愈合，A组骨折愈合时间为（14.73±2.05）周，B组为（17.27±2.60）周，两组比较差异有统计学意义（=-2.960，=0.006）。随访期间，未出现假体松动、假体周围感染、关节僵硬或内固定物松动等并发症。术后3、6及12个月时，A组Harris评分明显优于B组（<0.05）。
与钛缆环扎术相比，采用形状记忆合金环抱器固定温哥华B2型股骨假体周围骨折可促进骨折愈合，缩短手术时间，减少术中出血量，患者可更早进行功能锻炼，更好地恢复关节功能。
