在初次全髋关节置换术中使用环扎钢丝治疗术中温哥华B1型骨折的结果：一项关于临床和影像学结果的回顾性队列研究。

Results of Utilizing Cerclage Wires in the Management of Intraoperative Vancouver B1 Fractures in Primary Total Hip Arthroplasties: A Retrospective Cohort Investigation into Clinical and Radiographic Outcomes.

作者信息

Rocchi Caterina, Di Matteo Vincenzo, Chiappetta Katia, Grappiolo Guido, Loppini Mattia

机构信息

Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy.

Adult Reconstruction and Joint Replacement Service, Division of Orthopaedics and Traumatology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168 Roma, Italy.

出版信息

J Clin Med. 2024 Jan 31;13(3):819. doi: 10.3390/jcm13030819.

DOI:10.3390/jcm13030819

PMID:38337513

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10856186/

Abstract

BACKGROUND

Due to an increase in total hip arthroplasties (THAs), the incidence of periprosthetic hip fractures (PPHFs) is forecast to rise considerably in the next decades, with Vancouver B1 fractures (VB1) accounting for one third of total cases. Femur fixation with cerclages (with or without screws) is considered the current treatment option for intraoperative VB1.

METHODS

The study retrospectively includes data from patients who developed VB1 PPHFs during THAs from 3 December 2020 to 30 November 2022. The primary outcome of this study was to identify the reintervention-free survival rate. The secondary aim was to determine clinical and radiographic assessment at follow-up, based on Harris hip score (HHS) and limb length discrepancy (LLD).

RESULTS

Thirty-seven patients with a mean age of 60.03 ± 15.49 (22 to 77) years old were included. Overall, the Kaplan-Meier analysis estimated a reoperation-free survival rate of 99% (CI 95%) at 6 months. The mean limb length discrepancy (LLD) improved from -3.69 ± 6.07 (range -27.9 to 2.08) mm to 0.10 ± 0.67 (range -1.07 to 1.20) mm. The mean HHS improved from 42.72 ± 14.37 (range 21.00-96.00) to 94.40 ± 10.32 (range 56.00-100.00).

CONCLUSIONS

The employment of cerclage wires represents an effective strategy for handling intraoperative VB1 fractures. Level III retrospective cohort study.

摘要

背景

由于全髋关节置换术（THA）数量的增加，预计在未来几十年中，假体周围髋关节骨折（PPHF）的发生率将大幅上升，其中温哥华B1型骨折（VB1）占总病例的三分之一。使用环扎带（带或不带螺钉）固定股骨被认为是目前术中VB1骨折的治疗选择。

方法

本研究回顾性纳入了2020年12月3日至2022年11月30日期间在THA手术中发生VB1型PPHF的患者数据。本研究的主要结局是确定无再次干预生存率。次要目的是根据Harris髋关节评分（HHS）和肢体长度差异（LLD）确定随访时的临床和影像学评估结果。

结果

纳入37例患者，平均年龄为60.03±15.49（22至77）岁。总体而言，Kaplan-Meier分析估计6个月时无再次手术生存率为99%（95%CI）。平均肢体长度差异（LLD）从-3.69±6.07（范围-27.9至2.08）mm改善至0.10±0.67（范围-1.07至1.20）mm。平均HHS从42.72±14.37（范围21.00 - 96.00）提高到94.40±10.32（范围56.00 - 100.00）。