Jung Soo-Hwan, Kim Chul-Ho, Chang Jae Suk, Kim Ji Wan
Department of Orthopaedic Surgery, Busan Paik Hospital, College of Medicine, Inje University, Busan, Republic of Korea.
Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro, 43-gil, Songpa-gu, Seoul, Republic of Korea.
BMC Musculoskelet Disord. 2025 May 22;26(1):505. doi: 10.1186/s12891-025-08762-1.
This study compared the clinical and radiologic outcomes of well-fixed periprosthetic femoral fractures after hip arthroplasty according to the use of single plate fixation with additional attachment plate device (group 1) or not (group 2).
Retrospective data were obtained from a single center by reviewing medical records of patients who underwent reduction and internal fixation of Vancouver type B1 and C periprosthetic femoral fractures between June 2006 and June 2021. The study analyzed patient demographics, fracture characteristics, surgical details, functional outcomes (Harris hip score [HHS] and Koval score at 1-year follow-up), reoperation rates, and radiologic findings. In this study, nonunion and malunion were defined as indicators of "healing problems."
Among the 32 included patients (group 1: 15; group 2: 17), fractures resulted from high-energy (six cases) and low-energy (26 cases) injuries, with no open fractures. The fractures included 21 cases of Vancouver type B1 and 11 cases of type C. One patient (6.7%) in group 1 required revision surgery. Excellent or good outcomes were observed in 100% of group 1 and 88.2% of group 2 patients according to Beals-Tower criteria (p = 0.031). Healing problems occurred in 6.7% and 41.2% of patients in groups 1 and 2, respectively (p = 0.03). HHS score, Koval score, union time, or femoral alignment did not differ significantly between the two groups (p > 0.05).
Using an additional plate in the treatment of well-fixed periprosthetic femoral fractures yielded better clinical outcomes compared to cases without an additional plate. Lower rates of nonunion or delayed union and improved overall healing were observed in the augmented group.
本研究比较了髋关节置换术后使用单钢板固定并附加连接钢板装置（第1组）或不使用附加连接钢板装置（第2组）的牢固固定的人工关节周围股骨骨折的临床和影像学结果。
通过回顾2006年6月至2021年6月期间接受温哥华B1型和C型人工关节周围股骨骨折复位及内固定的患者的病历，从单一中心获取回顾性数据。该研究分析了患者人口统计学、骨折特征、手术细节、功能结果（1年随访时的Harris髋关节评分[HHS]和Koval评分）、再次手术率和影像学表现。在本研究中，骨不连和畸形愈合被定义为“愈合问题”的指标。
在纳入的32例患者中（第1组：15例；第2组：17例），骨折由高能损伤（6例）和低能损伤（26例）导致，无开放性骨折。骨折包括21例温哥华B1型和11例C型。第1组中有1例患者（6.7%）需要翻修手术。根据Beals-Tower标准，第1组100%的患者和第2组88.2%的患者获得了优秀或良好的结果（p = 0.031）。第1组和第2组患者中分别有6.7%和41.2%出现愈合问题（p = 0.03）。两组之间的HHS评分、Koval评分、愈合时间或股骨对线情况无显著差异（p > 0.05）。
与不使用附加钢板的情况相比，在治疗牢固固定的人工关节周围股骨骨折时使用附加钢板可产生更好的临床结果。在增加使用附加钢板的组中，骨不连或延迟愈合的发生率较低，整体愈合情况得到改善。
