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应用股骨内外侧支撑异体骨及保留假体治疗全肘关节置换术后假体周围肱骨干骨折:1例报告

Periprosthetic Humeral Shaft Fracture about Total Elbow Arthroplasties Managed with Medial and Lateral Femoral Strut Allografts and Implant Retention: A Case Report.

作者信息

Ketelaar Elise, McDonald Mike, Dietz James

机构信息

Department of Orthopedic Surgery, Corewell Health, United States, MI.

Department of Orthopedic Trauma Surgery, Munson Health, United States, MI.

出版信息

J Orthop Case Rep. 2025 Sep;15(9):240-244. doi: 10.13107/jocr.2025.v15.i09.6084.

Abstract

INTRODUCTION

Expanding indications for total elbow arthroplasty in recent years have led to increased occurrence of complications, such as periprosthetic elbow fracture, which can occur in up to 12% of cases. Several management options for periprosthetic elbow fracture have been suggested in literature; however, there is currently no accepted guideline for treatment.

CASE REPORT

We present two cases of periprosthetic humerus fractures without implant loosening multiple years after the index procedures. They were treated with open reduction internal fixation (ORIF) utilizing a plate with medial and lateral cortical strut femoral allografting with implant retention.

CONCLUSION

Two cases of periprosthetic humerus fractures about total elbow arthroplasties were successfully treated with ORIF with medial and lateral cortical strut augmentation. Treatment for periprosthetic elbow fractures should be tailored to each patient based on factors, such as stability of implant, bone stock, and patient goals.

摘要

引言

近年来,全肘关节置换术的适应症不断扩大,导致并发症发生率增加,如假体周围肘关节骨折,其发生率可达12%。文献中已提出几种假体周围肘关节骨折的处理方法;然而,目前尚无公认的治疗指南。

病例报告

我们报告两例在初次手术后多年出现的假体周围肱骨骨折,且植入物未松动。采用切开复位内固定(ORIF)治疗,使用带有内侧和外侧皮质支撑的股骨同种异体骨移植钢板并保留植入物。

结论

两例全肘关节置换术后的假体周围肱骨骨折通过ORIF联合内侧和外侧皮质支撑增强术成功治疗。假体周围肘关节骨折的治疗应根据植入物稳定性、骨量和患者目标等因素为每位患者量身定制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7300/12422655/252b483d0dc7/JOCR-15-240-g001.jpg

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