- 期刊
Postoperative Periprosthetic Fracture of Femur with Femoral Stem in Situ - A Retrospective Review of 45 Cases
人工髖關節置換術後發生股骨骨折─45個病例回朔性研究
並列摘要
A retrospective analysis of 45 cases (33 men and 12 women)of postoperative Periprosthetic fractures was performed between January 1988 and June 2001. The fractures were classified and analyzed according to Duncan’s classification of periprosthetic fracture. The clinical outcome of surgical treatment in all the seven cases of type A fracture was good. Of the 24 cases of type B1 periprosthetic fractures, 23 were treated with open reduction and internal fixation; six with wiring , 14 with plating, and three with cable plating. Only one case received conservative treatment with cast. The follow up result showed good result in all the six patients treated by open reduction with wiring. Of the 14patients with type B1 periprosthetic fracture treated by dynamic compression plating, 11 had good and three had poor results. Of the three cases treated with cable plating, two had good and one had poor results. The only case treated by casting had poor result. In the type B2 periprostheetic fracture, 10 cases were treated with revision total hip replacement, eight with cemented long stem and wiring and two and two with structural allograft and wiring. Of the eight patients treated by revision total hip replacement with cemented long stem and wiring, six had good had good and two had poor outcome. Of the 2 cases treated by revision total hip replacement with structural allograft and wiring, one had good and the other had poor outcome. The only case of type B3 fracture which was treated by revision total hip replacement with cemented stem and wiring had a food result. In the three cases of type C periprosthetic fracture, one was treated with open reduction with plating, the second with open reduction with lag screw and the third by casting. All of the three cases had good results. The results of this study showed that treatment of postoperative of femur with femoral stem in situ were quite variable. After analyzing the clinical outcome of 45 cases of postoperative oeriprostheetic fractures, and our clinical experience, we proposed an ideal algorithm for the treatment of the periprosthetic fracture of femur following hip replacement surgery.
延伸閱讀
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