记忆合金抓握式接骨板结合自体髂骨植骨治疗Vancouver B_1型股骨假体周围骨折.pdf

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1、华西医学2012，27(12)WestChinaMedicalJournal，Vo1．27。No．12Dec．2012l849论著记忆合金抓握式接骨板结合自体髂骨植骨治疗VancouverB1型股骨假体周围骨折李程旭，范洪武，高天敏【摘要】目的探讨人工髋关节置换术后VancouverB型股骨假体周围骨折的治疗方法。方法2006年4月一2011年2月采用记忆合金抓握式接骨板固定结合自体髂骨植骨治疗6例VancouverB型股骨假体周围骨折。其中男2例，女4例；年龄55～78岁，平均68．5岁。6例均为初次行人工

2、关节置换术后6个月～3年，平均18．4个月发生假体周围骨折；骨折至手术时间为3～6d，平均4．2d。结果术后切口均I期愈合，无深静脉血栓形成、肺部感染、肺栓塞等并发症发生。6例均获随访，随访时间13个月～4年，平均28．6个月。x线片示骨折全部愈合，愈合时间12～20周，平均14．8周。末次随访时Harris评分76～93分，平均83．6分；获优3例，良3例。无1例出现接骨板折断、松动，骨折再移位、骨不连、股骨假体松动等并发症。结论记忆合金抓握式接骨板结合自体髂骨植骨治疗VancouverB，型股骨假体周围骨

3、折具有固定可靠、操作简便的特点，可获满意临床疗效。【关键词】人工髋关节置换；股骨假体周围骨折；记忆合金抓握式接骨板；自体髂骨植骨【文献标识码】AUsingShapeMemoryAlloyEmbracingFixatorandSelf-iliumGraftingtoSurgicallyTreatVancouverType—B1PeriprostheticFemoralFracturesLICheng-xu．FANHong-wu．GAOTian—min．DepartmentofOrthopedicsSurgery

4、,FengduCoun~PeopleHospital,Fengdu,Chongqing408200,PR．China[Abstract]ObjectiveToexploreasurgicalmethodfortreatingVancouvertype-B1periprostheticfemoralfracturesafterartificialhipreplacementsurgery．MethodsBetweenApril2006andFebruary2011，wetreated6casesofVancou

5、vertype·Blperiprostheticfemoralfractureswithshapememoryalloyembracingfixatorandself-iliumgraftinginOurhospita1．Therewere2malesand4females，agedbetween55and78years，averagingat68．5．Allsixpatientsunderwentartificialhipreplacementsurgeryforthefirsttime．Thetimebe

6、tweenthereplacementsurgeryandthedevelopmentofperiprostheticfemoralfracturesrangedfrom6monthsto8yearswithanaverageof18．4months．Andthetimebetweenthefracturesandsurgeryforthefracturesrangedfrom3to6dayswithanaverageof4．2days．ResultsAllfractureswereprovedtobehea

7、ledwithnocomplicationssuchasdeepveinthrombosis，lunginfection，orlungembolism．Allsixpatientswerefollowedupfor13monthsto4years，averaging28．6months．Xrayexaminationshowedthatallfractureswerehealedwithin12to20weeks，averaging14．8weeks．TheHarrisscorewasbetween76and

8、93，withanaverageof83．6，andtherewerethreecasesgettinganexcellentandtheotherthreeagoodoutcome．Noboneplatebreakingorloosening，fracturere—shifting，bonenonunion，orperioprostheticfemorallooseningoccurred．Con