Lerner Alexander, Jakusonoka Ruta, Jumtins Andris, Rothem David
Department of Orthopaedics, Riga Stradins University, Latvia.
Department of Orthopaedic Surgery, Ziv Medical Center, Zefat, Israel.
J Orthop Case Rep. 2023 Sep;13(9):33-37. doi: 10.13107/jocr.2023.v13.i09.3866.
Multiple treatment options and internal and external devices have been recommended for periprosthetic fractures management around total knee arthroplasty.
We present the case of the high-energy bifocal periprosthetic fractures of the femur and the tibia after total knee prosthesis following excision of a tumor. One of the fractures was an open tibial fracture Gustilo Type IIIB and the other - comminuted subtrochanteric fracture of the femur with extrusion of periprosthetic cement pieces out from the bone defect. The Ilizarov circular external fixator was used for the skeletal stabilization and early functional treatment in this compound case.
The use of Ilizarov external fixator for patients with complex periprosthetic fractures, who present severe technical difficulties in bone stabilization, especially by concomitant severe soft-tissue damage after high-energy injuries, is a good surgical alternative.
对于全膝关节置换周围的假体周围骨折处理，已推荐了多种治疗选择以及内外部装置。
我们呈现了1例肿瘤切除后全膝关节假体周围发生的股骨和胫骨高能双灶性假体周围骨折病例。其中1处骨折为开放性胫骨骨折（ Gustilo IIIB型），另一处为股骨转子下粉碎性骨折，假体周围骨水泥块从骨缺损处挤出。在这个复合病例中，使用了伊利扎洛夫环形外固定器进行骨骼稳定和早期功能治疗。
对于假体周围复杂骨折患者，尤其是在高能损伤后伴有严重软组织损伤，在骨骼稳定方面存在严重技术困难时，使用伊利扎洛夫外固定器是一种良好的手术选择。
