人工髋关节置换术后股骨假体周围骨折的分类及治疗

被引：17

作者：

王勇

蒋建农

都斌

张盘军

张雷炎

郝思春

陈俊

焦杰君

王纪锋

机构：

[1] 江苏大学附属宜兴市人民医院骨科

来源：

中华创伤杂志 | 2014年 / 11期

关键词：

关节成形术,置换,髋; 假体周围骨折; 翻修;

D O I：

暂无

中图分类号：

R687.4 [关节手术];

学科分类号：

100220 [骨科学];

摘要：

目的探讨人工髋关节置换术后股骨假体周围骨折(periprosthetic femoral fracture,PFF)的分类方法及治疗策略。方法选择2006年1 1月—2013年10月人工髋关节置换术后PFF患者22例(22髋),其中男13例,女9例;年龄51～91岁,平均76.8岁。按照改良Vancouver分类:TG型1例,Al型1例,B1型6例,B2型10例,B3型1例,C型3例。采取非手术治疗2例,手术治疗20例,其中9例行内固定,11例行股骨长柄假体翻修。末次随访时采用Harris评分行临床疗效评估,采用Beals和Tower标准行假体周围骨折影像学评估,记录相关并发症。结果 2例分别于伤后3个月和5个月死亡。其余20例获得平均3年(1～6年)的随访,末次随访时Harris评分平均为85.4分(50～100分)。骨折均获得愈合,愈合时间平均为4.8个月(3～8个月)。PFF影像学评估按照Beals和Tower标准:优16例,良1例,差3例。并发症:1例B1型骨折术后发生浅表感染,1例C型骨折术后6个月发生钢板远端股骨骨折,1例B2型骨折术后4个月发生B1型骨折。无畸形愈合、内固定失效、脱位、假体松动等并发症发生。结论改良Vancouver分类对于PFF治疗方法的选择具有指导意义,按照不同的分类选择相应的治疗方法可以获得满意的临床疗效。

引用

共 16 条

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