CAJ | 학술논문

目的：探讨髋关节置换术中、术后股骨假体周围骨折的原因、治疗方法及预防策略。方法回顾性分析2007-2012我院治疗的34例股骨假体周围骨折，包括20例术中骨折及14例术后骨折。按Vancouver分型，AG型骨折4例，AL型骨折11例，B1型骨折12例，B2型骨折7例。结果34例中31例获得随访，平均随访时间2.8年(1~4年)，均达到骨性愈合，末次随访时髋关节Harris评分平均为88.4分，VAS评分为1.2分。末次随访时所有患者均不需扶拐行走，25例步态正常，6例轻度跛行，4例诉偶有大腿疼痛。所有病例假体稳定性良好，无松动迹象。所有切口均甲级愈合，无骨折不愈合、钢板断裂、感染、症状性血栓形成等并发症出现。31例患者均对手术效果表示满意。结论按Vancouver分型规范化治疗股骨假体周围骨折能取得令人满意的疗效。完善的术前准备、规范的手术操作及术后定期随访是预防股骨假体周围骨折的有效策略。
목적：탐토관관절치환술중、술후고골가체주위골절적원인、치료방법급예방책략。방법회고성분석2007-2012아원치료적34례고골가체주위골절，포괄20례술중골절급14례술후골절。안Vancouver분형，AG형골절4례，AL형골절11례，B1형골절12례，B2형골절7례。결과34례중31례획득수방，평균수방시간2.8년(1~4년)，균체도골성유합，말차수방시관관절Harris평분평균위88.4분，VAS평분위1.2분。말차수방시소유환자균불수부괴행주，25례보태정상，6례경도파행，4례소우유대퇴동통。소유병례가체은정성량호，무송동적상。소유절구균갑급유합，무골절불유합、강판단렬、감염、증상성혈전형성등병발증출현。31례환자균대수술효과표시만의。결론안Vancouver분형규범화치료고골가체주위골절능취득령인만의적료효。완선적술전준비、규범적수술조작급술후정기수방시예방고골가체주위골절적유효책략。
Objective To explore the causes, treatment and prevention strategies of periprosthetic femur frac-ture during and after total hip arthroplasty. Methods Thirty-four cases with periprosthetic femur fracture were re-viewed from 2007 to 2012, including 20 intraoperative fracture cases and 14 postoperative fracture cases. Results 31 patients were followed up, and the average follow-up period was 2.8 years (1~4 years). The mean Harris hip score was 88.4 and VAS was 1.2. No patient used any kind of walking support. 6 patients had a slight limp and 4 patients report-ed slight thigh pain. All the stems were stable. No ununion, infection or symptomatic thrombus happened. All the 31 patients expressed satisfaction with the outcome. Conclusion Satisfactory results can be achived in the premise of standardized treatment according to Vancouver classification. Perfect preoperative preparation, standardizd interlend-ing procedure and regular following up are effective prevention strategies for periprosthetic fractures.