CAJ | 학술논문

目的探讨全髋关节置换术后股骨假体周围骨折的治疗方法.方法选择全髋关节置换术后假体周围骨折患者9例.按照Vancouver分型:A型1例,B1型5例,B2型2例,C型1例.采用保守治疗1例,8例行手术治疗,5例行切开复位记忆合金环抱器内固定加髂骨块植骨治疗,3例行髋关节长柄假体翻修钢丝捆扎髂骨植骨术.结果 8例患者获随访,随访时间8 ～21个月,平均14.2个月,除1例假体松动外,均无骨折不愈合、感染、畸形愈合、内固定断裂等并发症.结论全髋关节置换术后股骨假体周围骨折,Vancouver分型方法包括了骨折的位置,骨折稳定性,假体松动情况,股骨近段的骨量对于临床治疗有很好的指导意义.对于A型骨折,假体稳定,可以采用保守治疗,B1型、B2型和C型骨折在身体条件允许的情况下则应尽量采用积极的手术治疗.如果伴有假体松动最好能一期行长柄假体置换.
목적 탐토전관관절치환술후고골가체주위골절적치료방법.방법 선택전관관절치환술후가체주위골절환자9례.안조Vancouver분형:A형1례,B1형5례,B2형2례,C형1례.채용보수치료1례,8례행수술치료,5례행절개복위기억합금배포기내고정가가골괴식골치료,3례행관관절장병가체번수강사곤찰가골식골술.결과 8례환자획수방,수방시간8 ～21개월,평균14.2개월,제1례가체송동외,균무골절불유합、감염、기형유합、내고정단렬등병발증.결론 전관관절치환술후고골가체주위골절,Vancouver분형방법포괄료골절적위치,골절은정성,가체송동정황,고골근단적골량대우림상치료유흔호적지도의의.대우A형골절,가체은정,가이채용보수치료,B1형、B2형화C형골절재신체조건윤허적정황하칙응진량채용적겁적수술치료.여과반유가체송동최호능일기행장병가체치환.
Objective To explore the treatment methods of periprosthetic femur fracture after hip arthroplasty.Methods 9 patiens with periprosthetic femur fracture after hip arthroplasty were selected.According to Vancouver classification,there were 1 case in A type,5 cases in B1 type,2 cases in B2 type,1 case in C type.One case were treated by nonoperative method and the other 8 cases were treated by operative method,including 5 cases treated by memory alloy embracing fixator and internal fixation,3 cases treated by long stem prosthetic replacement and iliac bone graft.Results 8 cases were followed up for 8 to 21 months,average 14.2 months.All fractures were united well with good alignment and internal fixation failure except one prosthesis loosing was observed.Conclusion For periprosthetic femur fracture after hip arthroplasty,Vancouver classification methods include the location and stability of the fracture,prosthesis loosening,and the femur in bone mass is importance to the clinical treatment.As to A type fracture,prosthesis is stable,and the conservative treatment can be choosed.As to B1 and B2 type fracture,the aggressive surgical treatment can be choosed based on patients' general condition.If prosthesis loosening after artificial hip arthroplasty,the patients should treated with long stem prosthetic replacement.