桥接组合内固定系统治疗Vancouver B1和C型股骨假体周围骨折
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翁益平 WENG Yi-ping 南京医科大学附属常州市第二人民医院骨科, 江苏 常州 213003 Department of Orthopaedics, Changzhou 2nd People's Hospital Affilited to Nanjin Medcial University, Changzhou 213003, Jiangsu, China  
郁忠杰 YU Zhong-jie 南京医科大学附属常州市第二人民医院骨科, 江苏 常州 213003 Department of Orthopaedics, Changzhou 2nd People's Hospital Affilited to Nanjin Medcial University, Changzhou 213003, Jiangsu, China  
孙荣彬 SUN Rong-bin 南京医科大学附属常州市第二人民医院骨科, 江苏 常州 213003 Department of Orthopaedics, Changzhou 2nd People's Hospital Affilited to Nanjin Medcial University, Changzhou 213003, Jiangsu, China  
徐南伟 XU Nan-wei 南京医科大学附属常州市第二人民医院骨科, 江苏 常州 213003 Department of Orthopaedics, Changzhou 2nd People's Hospital Affilited to Nanjin Medcial University, Changzhou 213003, Jiangsu, China  
张煜 ZHANG Yu 南京医科大学附属常州市第二人民医院骨科, 江苏 常州 213003 Department of Orthopaedics, Changzhou 2nd People's Hospital Affilited to Nanjin Medcial University, Changzhou 213003, Jiangsu, China dryuzhang@126.com 
期刊信息:《中国骨伤》2020年,第33卷,第4期,第371-375页
DOI:10.12200/j.issn.1003-0034.2020.04.016
基金项目:
中文摘要:

目的:评价采用桥接组合内固定系统治疗人工髋关节置换术后股骨假体周围骨折Vancouver B1型和C型的临床效果。

方法:自2016年10月至2018年6月,股骨假体周围骨折温哥华B1型和C型患者5例,男2例,女3例;年龄68,70,74,75,79岁,平均73.2岁;B1型骨折4例,C型骨折1例。受伤原因:交通伤1例,跌倒4例。采用切开复位桥接组合内固定治疗。术后通过临床和影像学检查随访患者有无并发症、骨折愈合时间,行Parker活动评分。

结果:术后5例患者伤口均愈合,无感染发生。有1例经静脉造影证实发生深静脉血栓。5例患者均获随访,时间2,8,9,10,15个月。其中1例于术后2个月因心肌梗塞死亡。4例患者均骨折愈合,平均愈合时间12.5周。未发现复位丢失和内固定失效,术后2例患者可无保护下负重行走,1例需依靠单拐辅助。1例再次假体周围骨折患者术前依靠单拐行走,术后依靠双拐于室内活动。Parker活动评分平均恢复至术前的51.8%。

结论:桥接组合内固定系统可以用于固定股骨假体稳定的人工髋关节置换后骨折。
【关键词】假体周围骨折  骨折固定术,内  关节成形术,置换,髋
 
Treatment of femoral periprosthetic fracture of Vancouver type B1 and C with bridge combined internal fixation system
ABSTRACT  

Objective: To evaluate the clinical effect of bridge combined internal fixation system in the treatment of periprosthesis fracture of femur after hip replacement.

Methods: From October 2016 to June 2018,5 patients of periprosthesis fractures of femur classified type B1 and type C in Vancouver were treated by open reduction and bridging combined with internal fixation,including 2 males and 3 females,with ages of 68,70,74,75,79 years;type B1 fractures in 4 and type C fractures in 1. Causes of injury:1 case of traffic injury,4 cases of fall. After the operation,the patients were followed up for complications and fracture healing time by clinical and imaging examination,and Parker activity score was performed.

Results: The wounds of 5 patients healed without infection. One case of DVT was confirmed by venography. Five patients were followed up, and the durations were 2,8,9,10,15 months. One patient died of myocardial infarction 2 months after operation. The average healing time was 12.5 weeks. No loss of reduction or failure of internal fixation was found. Two patients could walk without protection and 1 patient needed to rely on single crutch. One case of periprosthetic fracture had to walk with a single crutch before operation and move indoors with two crutches after operation. The average Parker activity score was 51.8% before operation.

Conclusion: The bridge combined internal fixation system can be used to fix the fracture after hip replacement with stable femoral prosthesis.
KEY WORDS  Periprosthetic fractures  Fracture fixation,internal  Arthroplasty,replacement,hip
 
引用本文,请按以下格式著录参考文献:
中文格式:翁益平,郁忠杰,孙荣彬,徐南伟,张煜.桥接组合内固定系统治疗Vancouver B1和C型股骨假体周围骨折[J].中国骨伤,2020,33(4):371~375
英文格式:WENG Yi-ping,YU Zhong-jie,SUN Rong-bin,XU Nan-wei,ZHANG Yu.Treatment of femoral periprosthetic fracture of Vancouver type B1 and C with bridge combined internal fixation system[J].zhongguo gu shang / China J Orthop Trauma ,2020,33(4):371~375
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