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中华关节外科杂志(电子版) ›› 2018, Vol. 12 ›› Issue (03) : 416 -420. doi: 10.3877/cma.j.issn.1674-134X.2018.03.021

所属专题: 文献

临床经验

Zweymυ¨ller型柄髋关节置换术后股骨侧假体周围骨折的手术治疗
方超华1, 龚凯2, 王识程1, 狄正林1, 何志勇1, 章军辉1,()   
  1. 1. 315000 宁波市第六医院关节外科
    2. 310053 杭州,浙江中医药大学第二临床医学院
  • 收稿日期:2017-05-22 出版日期:2018-06-01
  • 通信作者: 章军辉

Surgical treatment of femoral periprosthetic fracture following hip arthroplasty with Zweymυ¨ller stem

Chaohua Fang1, Kai Gong2, Shicheng Wang1, Zhenglin Di1, Zhiyong He1, Junhui Zhang1,()   

  1. 1. Department of Joint Surgery, Ningbo sixth Hospital, Ningbo 315000, China
    2. 2nd Clinical Medicine College, Zhejiang Chinese medical university, Hangzhou 310053, China
  • Received:2017-05-22 Published:2018-06-01
  • Corresponding author: Junhui Zhang
  • About author:
    Corresponding author: Zhang Junhui, Email:
引用本文:

方超华, 龚凯, 王识程, 狄正林, 何志勇, 章军辉. Zweymυ¨ller型柄髋关节置换术后股骨侧假体周围骨折的手术治疗[J]. 中华关节外科杂志(电子版), 2018, 12(03): 416-420.

Chaohua Fang, Kai Gong, Shicheng Wang, Zhenglin Di, Zhiyong He, Junhui Zhang. Surgical treatment of femoral periprosthetic fracture following hip arthroplasty with Zweymυ¨ller stem[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2018, 12(03): 416-420.

目的

报道应用Profemur?Z柄行初次髋关节置换术后股骨侧假体周围骨折病例6例手术治疗后效果。

方法

纳入宁波市第六医院关节外科2009至2017年期间因终末期髋关节病或股骨颈骨折行初次髋关节置换术,术后外伤后发生假体周围骨折病例共6例(7髋)。其中5髋为长螺旋、长斜形或粉碎性骨折,2髋为短斜形骨折;Vancouver B1型2髋,B2型5髋,术中股骨侧假体根据不同骨折情况选用不同翻修方式,分别行单纯骨折复位内固定术和关节翻修术加骨折复位内固定术,并随访其疗效。

结果

本组患者术后随访均未出现假体松动或假体周围骨溶解等并发症,所有病例未发生术后并发症。术后3月X线显示骨折均愈合,患髋功能恢复好,末次随访髋关节功能HSS评分平均(85.5±4.5)分。

结论

Profemur?Z柄初次髋关节置换术后发生假体周围骨折可根据骨折分型给予内固定或翻修手术治疗,术后随访显示功能恢复好,骨折与假体形态设计的相关性需要生物力学研究。

Objective

To report therapeutic effects of surgical treatment on six cases of femoral periprosthetic fracture after primary hip arthroplasty with Profemur? Z stem.

Methods

Six cases (seven hips) who received primary hip arthroplasty for end stage of hip osteopathy or femoral neck fracture were collected during 2009 to 2017. All the cases used the Profemur? Z stem and all of them had no metabolic bone diseases but suffered from postoperative femoral periprosthetic fractures after trauma, including five hips of long spiral, long oblique or comminuted fractures and two hips of short oblique fracture. Two hips were Vancouver B1 type and five hips were B2 type. Surgeries were performed according to Vancouver classification, open reduction and internal fixation(ORIF), or revision arthroplasty plus ORIF were conducted respectively.

Results

No postoperative complication happened, and fractures were all healed at three months postoperatively. Good hip function was obtained in all the cases; HSS score was (85.5±4.5) on average at the time of latest follow-up.

Conclusion

The femoral periprosthetic fractures following primary hip arthroplasty with Profemur? Z stem can be effectively l treated by surgical treatment according to Vancouver classification.

图1 双侧Vancouver B2型骨折,行大号Profemur? Z柄加用捆绑带翻修术前后X线片。图A 双侧全髋关节置换术后X线片,周围骨质正常;图B 双侧全髋关节置换术后X线片,双侧股骨假体周围骨折(Vancouver B2型);图C 双侧髋关节翻修术后X线片,大号Profemur? Z柄翻修加用捆绑带固定
图3 左侧Vancouver B1型骨折,行MP柄加用捆绑带翻修术前后X线片。图A 左侧全髋关节置换术后X线片,示假体周围骨折(Vancouver B2型);图B 左侧髋关节翻修术后X线片,MP柄翻修加用捆绑带固定术后
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