Porsch M, Galm R, Hovy L, Starker M, Kerschbaumer F
Abteilung für Rheumaorthopädische Universitätsklinik Frankfurt/Main.
Z Orthop Ihre Grenzgeb. 1996 Jan-Feb;134(1):16-20. doi: 10.1055/s-2008-1037412.
Periprosthetic femur fractures are one of the most severe complications in hip surgery. Osteoporosis as seen in patients with rheumatoid arthritis could favour such fractures, which are located mostly between the stems of the hip and knee prostheses. A traumatic event is not even required. The fracture rate increases with predisposing factors, such as preliminary changes of the prosthesis or osteoporosis. This paper reports two patients with rheumatoid arthritis (males, 54 and 71 years old) with femur fractures after total hip and knee replacements. Both had a severe osteoporosis caused by a long-term steroid therapy. Consecutively, both patients showed refractures of the femur with loosening of the osteosynthetic material, so that a total femur replacement was required. However, both patients are able to walk. To reduce the risk of femur fractures between the tips of knee and hip prostheses it is advisable to use knee prostheses without a proximal intramedullary stem. In this way pressure stress is reduced.
人工关节周围股骨骨折是髋关节手术中最严重的并发症之一。类风湿性关节炎患者中出现的骨质疏松可能会促使此类骨折的发生，这些骨折大多位于髋关节和膝关节假体的柄之间。甚至不需要创伤事件。骨折率会随着诸如假体的初步变化或骨质疏松等诱发因素而增加。本文报告了两名类风湿性关节炎患者（男性，54岁和71岁），他们在全髋关节和膝关节置换术后发生了股骨骨折。两人均因长期使用类固醇治疗而患有严重的骨质疏松。随后，两名患者均出现股骨再次骨折，内固定材料松动，因此需要进行全股骨置换。然而，两名患者都能够行走。为降低膝关节和髋关节假体尖端之间股骨骨折的风险，建议使用没有近端髓内柄的膝关节假体。通过这种方式可以减轻压力应力。
