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股骨远端假体周围骨折后行股骨远端置换：一例报告

Distal Femoral Replacement After Distal Femur Periprosthetic Fracture: A Case Report.

作者信息

Jamal Rayan, Shaqroon Hatem A, Ali Mohamad A, Farsi Sultan H

机构信息

Orthopedic Surgery, Prince Mohammed Bin Abdulaziz Hospital, Ministry of the National Guard - Health Affairs, Madinah, SAU.

Orthopedic Surgery, King Fahad Hospital, Ministry of Health, Madinah, SAU.

出版信息

Cureus. 2025 Jun 1;17(6):e85188. doi: 10.7759/cureus.85188. eCollection 2025 Jun.

DOI:10.7759/cureus.85188
PMID:40458384
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12127015/
Abstract

Distal femoral periprosthetic fractures present a complex challenge, particularly in elderly patients with comorbidities and poor bone quality. We report a case of a 62-year-old Saudi female with morbid obesity and a history of bilateral total knee arthroplasty (TKA) who sustained a distal femoral fracture after minor trauma. Due to limited bone stock and fracture proximity to the prosthesis, internal fixation was ruled out. The patient underwent successful revision TKA with distal femoral replacement (DFR). Postoperative recovery was good, and she was discharged on day 4 with a knee range of motion of 0-90°. This case underscores the viability of DFR as a limb-salvaging option, offering immediate weight-bearing and early mobilization.

摘要

股骨远端假体周围骨折是一项复杂的挑战，尤其是对于患有合并症且骨质较差的老年患者。我们报告一例62岁沙特女性病例，该患者患有病态肥胖症且有双侧全膝关节置换术（TKA）病史，在轻微创伤后发生股骨远端骨折。由于骨量有限且骨折部位靠近假体，排除了内固定治疗。该患者接受了成功的翻修TKA并进行了股骨远端置换（DFR）。术后恢复良好，她在第4天出院，膝关节活动范围为0-90°。该病例强调了DFR作为一种保肢选择的可行性，可实现立即负重和早期活动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49d1/12127015/bf6c538fc8fe/cureus-0017-00000085188-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49d1/12127015/35943ecd5931/cureus-0017-00000085188-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49d1/12127015/867a4a07b2b8/cureus-0017-00000085188-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49d1/12127015/8ea2320db15e/cureus-0017-00000085188-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49d1/12127015/bf6c538fc8fe/cureus-0017-00000085188-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49d1/12127015/35943ecd5931/cureus-0017-00000085188-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49d1/12127015/867a4a07b2b8/cureus-0017-00000085188-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49d1/12127015/8ea2320db15e/cureus-0017-00000085188-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49d1/12127015/bf6c538fc8fe/cureus-0017-00000085188-i04.jpg

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本文引用的文献

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Cureus. 2024 Sep 10;16(9):e69087. doi: 10.7759/cureus.69087. eCollection 2024 Sep.
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Periprosthetic Fractures After a Total Knee Arthroplasty.全膝关节置换术后的假体周围骨折。
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Distal Femoral Replacements for Acute Comminuted Periprosthetic Knee Fractures: Satisfactory Clinical Outcomes at Medium-Term Follow-up.急性粉碎性人工膝关节周围骨折的股骨远端置换术：中期随访的满意临床结果
Arthroplast Today. 2020 Dec 25;7:37-42. doi: 10.1016/j.artd.2020.11.014. eCollection 2021 Feb.
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Complication Rates after Lateral Plate Fixation of Periprosthetic Distal Femur Fractures: A Multicenter Study.外侧接骨板固定假体周围股骨远端骨折的并发症发生率：一项多中心研究。
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Revision Total Knee Arthroplasty for the Management of Periprosthetic Fractures.翻修全膝关节置换术治疗假体周围骨折
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