Schutzer S F, Grady-Benson J, Jasty M, O'Connor D O, Bragdon C, Harris W H
Department of Orthopedics, University of Connecticut, Farmington, USA.
J Arthroplasty. 1995 Dec;10(6):823-9. doi: 10.1016/s0883-5403(05)80082-8.
Intraoperative femoral fractures occur more frequently with cementless than with cemented components. In this study, the influence of controlled femoral fractures fixed with cerclage wires on rotational stability and bone ingrowth into porous-coated canine femoral components was evaluated. These data were compared with results of previous studies on unrecognized femoral fractures (not stabilized) and on the intact canine femur. Micromotion analysis revealed a significant increase in rotational instability in fractures not stabilized with cerclage wires (P < .05) compared with the intact femur. Experimentally created femoral fractures had a significantly deleterious effect on bone ingrowth even after cerclage wiring. This appears to be caused by a lack of bone ingrowth deep to the fracture and an increase in femoral component micromotion. In clinical practice, femoral fractures occurring during cementless total hip arthroplasty are a serious problem, and use of a cemented prosthesis is recommended if rotational stability of the stem cannot be ensured.
术中股骨骨折在使用非骨水泥型假体时比使用骨水泥型假体时更频繁发生。在本研究中，评估了用环扎钢丝固定的可控股骨骨折对多孔涂层犬股骨假体的旋转稳定性和骨长入的影响。这些数据与先前关于未识别的股骨骨折（未固定）和完整犬股骨的研究结果进行了比较。微动分析显示，与完整股骨相比，未用环扎钢丝固定的骨折旋转不稳定性显著增加（P < 0.05）。即使进行了环扎钢丝固定，实验性造成的股骨骨折对骨长入仍有显著的有害影响。这似乎是由于骨折深部缺乏骨长入以及股骨假体微动增加所致。在临床实践中，非骨水泥型全髋关节置换术中发生的股骨骨折是一个严重问题，如果不能确保假体柄的旋转稳定性，建议使用骨水泥型假体。
