中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (48): 9088-9095.doi: 10.3969/j.issn.2095-4344.2012.48.031

• 骨与关节学术探讨 academic discussion of the bone and joint • 上一篇    下一篇

人工髋关节置换后假体周围骨折的治疗

胡如印，田晓滨，孙 立，韩 伟，田家亮   

  1. 贵州省人民医院骨科，贵州省贵阳市 550002
  • 收稿日期:2012-06-04 修回日期:2012-07-15 出版日期:2012-11-25 发布日期:2012-11-25
  • 通讯作者: 田晓滨，主任医师，教授，硕士生导师，博士生导师，贵州省人民医院骨科，贵州省贵阳市 550002 txb6@vip.163.com
  • 作者简介:胡如印，男，1975年生，贵州省金沙县人，汉族，1996年遵义医学院毕业，主任医师，主要从事关节外科研究。 huruyin@yahoo.cn

Treatment of fractures around the prosthesis after total hip arthroplasty

Hu Ru-yin, Tian Xiao-bin, Sun Li, Han Wei, Tian Jia-liang   

  1. Department of Orthopedics, Guizhou Provincial People's Hospital, Guiyang 550002, Guizhou Province, China
  • Received:2012-06-04 Revised:2012-07-15 Online:2012-11-25 Published:2012-11-25
  • Contact: Tian Xiao-bin, Chief physician, Professor, Master’s supervisor, Department of Orthopedics, Guizhou Provincial People's Hospital, Guiyang 550002, Guizhou Province, China txb6@vip.163.com
  • About author:Hu Ru-yin, Chief physician, Department of Orthopedics, Guizhou Provincial People's Hospital, Guiyang 550002, Guizhou Province, China huruyin@yahoo.cn

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741

被引次数

19

摘要：

背景：股骨假体周围骨折是人工髋关节置换后常见的并发症之一，并且发病率在不断增加，改进股骨假体周围骨折的治疗方法及技术成为研究的课题之一。
目的：明确各种内固定对于人工髋关节置换后假体周围骨折的治疗效果，为治疗技术的改进以及患者生活质量的改善提供理论参考信息。
方法：分别对人工髋关节置换治疗中以及治疗后并发假体周围骨折的影响因素及内固定治疗方法进行实验数据分析，重点分析形状记忆合金环抱器和锁定钢板内固定治疗人工髋关节置换后假体周围骨折的临床效果，同时比较不同内固定方法对假体周围骨折的治疗效果。
结果与结论：患者的性别、年龄、假体的类型以及假体的稳定性均为人工髋关节置换后周围假体骨折发生的危险因素，非骨水泥型假体发生骨折的风险高于骨水泥型假体发生骨折的风险。对于人工髋关节置换后周围假体骨折治疗方法的选择，形状记忆合金环抱器内固定不损害假体周围骨皮质，并且具有固定稳固、操作简单、创伤较小、并发症少等优点，而锁定加压钢板结合钢缆内固定具有创伤小、对骨折断端血供干扰小、固定稳固等优点，2种内固定治疗均可以获得较好的临床治疗效果，但是相比较而言，锁定加压钢板内固定比形状记忆合金环抱器内固定治疗获得更好的临床效果。

关键词: 髋关节置换, 假体周围骨折, 内固定, 形状记忆合金环抱器, 锁定加压钢板, 钢缆环扎, 假体翻修, 股骨, 异体皮质骨板, 植骨

Abstract:

BACKGROUND: Fractures around femoral prosthesis are common complications after total hip arthroplasty, and the incidence rate is increased continuously, therefore, the improvement of methods and technology for the treatment of fractures around femoral prosthesis has become a research topic.
OBJECTIVE: To explore the therapeutic effect of various internal fixations for treatment of fractures around femoral prosthesis after total hip arthroplasty, and to provide a theoretical reference information for the improvement of treatment technology as well as the improvement of the quality of life in patients.
METHODS: The factors and internal fixation of the fractures around prosthesis during and after total hip arthroplasty were analyzed through experimental data analysis, especially the clinical effects of shape memory alloy embracing fixcator and locking plate internal fixation for the treatment of fractures around femoral prosthesis after total hip arthroplasty; and the effects of different internal fixations for the treatment of fractures around femoral prosthesis after total hip arthroplasty were compared.
RESULTS AND CONCLUSION: The age, years, type of prosthesis and the stability of the prosthesis were the risk factors of fractures around femoral prosthesis after total hip arthroplasty, such as the fracture risk of uncemented prosthesis was higher than that of the bone cement prosthesis. For the choice of internal fixation method for the treatment of fractures around prosthesis after total hip arthroplasty, shape memory alloy embracing fixcator could not damage the cortical bone around the prosthesis, and has the advantages of fixed solid, simple operation, less invasive and fewer complications, and so on, while the locking compression plate combined with steel cable internal fixation has the advantages of less trauma, little blood interference on the fracture fragments and fixed solid. Two kinds of internal fixation can obtain better clinical therapeutic effect, but the therapeutic effect of locking compression plate internal. fixation is bet ter than that of the shape memory alloy embracing fixcator internal fixation.

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