中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2010年
12期
1118-1121
,共4页
卜延民%张铁良%赵秀祥%于建华%郑得志
蔔延民%張鐵良%趙秀祥%于建華%鄭得誌
복연민%장철량%조수상%우건화%정득지
关节成形术,置换,髋%股骨骨折%骨折固定术,内
關節成形術,置換,髖%股骨骨摺%骨摺固定術,內
관절성형술,치환,관%고골골절%골절고정술,내
Arthroplasty,replacement,hip%Femoral fractures%Fracture fixation,internal
目的 分析髋关节置换术中股骨骨折的危险因素并探讨其处理方法.方法 对我科2002年11月-2009年11月收治的38例髋关节置换术中发生股骨骨折的患者资料进行回顾性分析.骨折分类按照Amstutz分型或美国骨科医师协会(AAOS)分型,并据此选择治疗方法.25例予术中内固定,包括14例单纯捆绑固定,5例钢板固定和6例大段异体骨结合钢丝捆绑带捆扎固定.有12例更换长柄假体.结果 平均随访4.5年(0.5～7.5年),有36例正常愈合,2例延迟愈合,有1例4年后假体柄松动需要翻修.结论 骨质疏松、术中暴力、髓腔发育异常和假体型号过大是术中股骨骨折的主要原因.按照骨折分型选择适当的治疗方法多能取得满意的临床效果.
目的 分析髖關節置換術中股骨骨摺的危險因素併探討其處理方法.方法 對我科2002年11月-2009年11月收治的38例髖關節置換術中髮生股骨骨摺的患者資料進行迴顧性分析.骨摺分類按照Amstutz分型或美國骨科醫師協會(AAOS)分型,併據此選擇治療方法.25例予術中內固定,包括14例單純捆綁固定,5例鋼闆固定和6例大段異體骨結閤鋼絲捆綁帶捆扎固定.有12例更換長柄假體.結果 平均隨訪4.5年(0.5～7.5年),有36例正常愈閤,2例延遲愈閤,有1例4年後假體柄鬆動需要翻脩.結論 骨質疏鬆、術中暴力、髓腔髮育異常和假體型號過大是術中股骨骨摺的主要原因.按照骨摺分型選擇適噹的治療方法多能取得滿意的臨床效果.
목적 분석관관절치환술중고골골절적위험인소병탐토기처리방법.방법 대아과2002년11월-2009년11월수치적38례관관절치환술중발생고골골절적환자자료진행회고성분석.골절분류안조Amstutz분형혹미국골과의사협회(AAOS)분형,병거차선택치료방법.25례여술중내고정,포괄14례단순곤방고정,5례강판고정화6례대단이체골결합강사곤방대곤찰고정.유12례경환장병가체.결과 평균수방4.5년(0.5～7.5년),유36례정상유합,2례연지유합,유1례4년후가체병송동수요번수.결론 골질소송、술중폭력、수강발육이상화가체형호과대시술중고골골절적주요원인.안조골절분형선택괄당적치료방법다능취득만의적림상효과.
Objective To analyze the risk factors related to intraoperative femur fracture in hip replacement and discuss the treatment countermeasures. Methods The medical records and radiographs of 38 patients with intraoperative femur fracture who were treated at Tianjin Orthopedic Hospital from December 2002 to December 2009 were retrospectively studied. Fractures were classified according to the Amstutz system or AAOS standard and the treatment methods were selected accordingly. Reduction and fixation was performed in 25 patients including 14 patients treated with interfragmentary or cerclage fixation, five with plate fixations and six with cortical strut graft. Shank prosthesis was replaced in 12 patients. Results The mean follow up period was 4.5 years, which showed successful union of the fractures in 36 patients and delayed union in two. Replacement of the prosthesis was needed in one patient for prosthesis loosening four years postoperatively. Conclusions Osteoporosis, violence, abnormal femur canal and over large prosthesis are the main causes of intraoperative femur fracture in hip replacement.Proper selection of treatment method according to fracture types may attain fracture union with a stable implant.
