摘要
[目的]探讨首次全髋关节置换术中股骨假体周围骨折的主要原因、预防措施及治疗方法.[方法]对2002年1月～2004年6月29例全髋关节置换术中出现骨折的原因进行回顾性分析.[结果]在588髋关节术中发生股骨骨折29例,发生率4.93%.采用Malory分型,其中Ⅰ型骨折22例,Ⅱ型骨折6例,Ⅲ型骨折1例.术中固定的28例骨折,除1例外其余27例均愈合,平均愈合时间10周.[结论]股骨近端解剖结构的异常、假体型号选择不当、过分追求假体与股骨皮质紧密区的过分紧密配合、骨质疏松等是造成首次全髋置换股骨骨折的主要原因.对于稳定的Ⅰ型骨折和Ⅱ型骨折行钢丝环扎术即可达到稳定假体和骨折的目的,对于合并骨质疏松、不稳定的骨折可行异体骨板支撑植骨术.
[ Objective] To investigate the main cause, precaution and treatment of intraoperative periprosthetic femur fractures in primary THR. [ Method] Retrospective study was made on 29 cases of patients who have intraoperative periprosthetic femur fractures from July 2002 to June 2004. [ Result] Intraoperative femur fracture occurred in 25 cases （4.93 % ） of 588 hips. There were 22 Mallory type Ⅰ fractures,6 type Ⅱ and 1 type Ⅲ. There were 28 case of fractures were fixed during operation,and 27 cases healed up at an average of 10 weeks except 1 case. [ Conclusion]The anatomical abnormal of proximal femur,inappropriate choice of prosthesis type attempting to maximize the degree of interference fit of prosthesis and femur in region of dense cortical bone, and osteoporosis were the main cause of femur fractures in primary total hip arthroplasty. To stablize type Ⅰ and type Ⅱ fractures ,cerclage wires were adequate for both implant and fracture stability, and in case of osteoporosis and instable fractures an allograft cortical struts can be added to supplement fixation.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2005年第18期1376-1378,共3页
Orthopedic Journal of China
