Agrawal Alok C, S Lohitesh, Sakale Harshal, Narayan Dash Rudra, Chauhan Shivam
Orthopaedics, All India Institute of Medical Sciences, Raipur, Raipur, IND.
Cureus. 2024 Sep 10;16(9):e69087. doi: 10.7759/cureus.69087. eCollection 2024 Sep.
Total femur replacement (TFR) is one of the most extensive endoprosthetic reconstruction procedures. The most common indication for the use of total femoral replacement is limb salvage in malignant bone tumors of the femur. This procedure is rarely performed outside the paradigm of oncological limb reconstruction. With the increased incidence of total hip and total knee replacements, complications of these procedures are also on the rise. Cases of complicated revision arthroplasties with severe bone loss, infection, and comminuted periprosthetic fractures may not have adequate residual bone stock for satisfactory fixation of megaprosthesis. With limited reconstruction options, most of these cases are offered lower limb amputation. TFR can be used as a limb salvage option in place of amputation in such cases. There have been a few case reports of TFR for non-oncological indications in the literature. We present a case of periprosthetic comminuted distal femur fracture with a loose megaprosthesis following a road traffic accident (RTA), which was managed with TFR. At four years of follow-up, the patient showed good radiological as well as clinical outcomes.
全股骨置换术（TFR）是最广泛的内置假体重建手术之一。使用全股骨置换术最常见的指征是股骨恶性骨肿瘤的保肢治疗。这种手术很少在肿瘤肢体重建的范例之外进行。随着全髋关节和全膝关节置换术发生率的增加，这些手术的并发症也在上升。伴有严重骨丢失、感染和假体周围粉碎性骨折的复杂翻修关节成形术病例可能没有足够的残余骨量来实现对大型假体的满意固定。由于重建选择有限，这些病例中的大多数都接受了下肢截肢术。在这种情况下，TFR可作为一种保肢选择来替代截肢术。文献中已有一些关于TFR用于非肿瘤指征的病例报告。我们报告一例道路交通事故（RTA）后假体周围股骨远端粉碎性骨折伴大型假体松动的病例，该病例采用TFR进行治疗。在四年的随访中，患者显示出良好的影像学和临床结果。
