Bernstein Brian P, Rivkin Gurion, Weil Yoram A, Greenberg Alexander, Madison Brian B, Areu Mapour M, Joda Omojowk B, Berry Kirsty Leigh, Nortje Marc
Department of Orthopaedics, University of Cape Town, Cape Town. South Africa.
Department of Orthopaedics, Hadassah Hebrew University Hospital, Jerusalem, Israel.
OTA Int. 2023 Mar 28;6(1 Suppl):e238. doi: 10.1097/OI9.0000000000000238. eCollection 2023 Mar.
Periprosthetic fractures of the distal femur have significant morbidity in both total hip and total knee arthroplasty (THA and TKA, respectively). The incidence of these fractures is growing, with the predominant mechanism of injury being a fall from a standing height and therefore considered fragility fractures. In many countries, improved public funding and a flourishing private health care sector, when coupled with increased life expectancy, translates to more older patients receiving both TKA and THA and therefore an increased prevalence of periprosthetic fractures and their associated complications. These fractures may occur below a long stem THA, above a TKA, or between the two (so-called "interprosthetic fracture"). We will outline fracture classification, risk factors, diagnosis, and treatment options, highlighting perspectives on treating these fractures in Israel, South Africa, and South Sudan. These countries represent differing access to resources, varied comorbidity factors, and differing health care systems. The points of difference and the points of similarity will be considered.
股骨远端假体周围骨折在全髋关节置换术和全膝关节置换术（分别为THA和TKA）中均具有较高的发病率。这些骨折的发生率正在上升，主要损伤机制是从站立高度跌落，因此被视为脆性骨折。在许多国家，公共资金的改善和蓬勃发展的私立医疗保健部门，再加上预期寿命的延长，意味着更多老年患者接受TKA和THA，从而导致假体周围骨折及其相关并发症的患病率增加。这些骨折可能发生在长柄THA下方、TKA上方或两者之间（所谓的“假体间骨折”）。我们将概述骨折分类、危险因素、诊断和治疗选择，重点介绍以色列、南非和南苏丹治疗这些骨折的观点。这些国家代表了不同的资源获取情况、不同的合并症因素和不同的医疗保健系统。将考虑差异点和相似点。
