目的分析组配式股骨假体髋关节翻修治疗全髋关节置换术后股骨假体周围骨折的近中期效果。方法回顾性分析2013年6月-2016年6月我院行组配式股骨假体髋关节翻修治疗的全髋关节置换术后股骨假体周围骨折20例临床资料,观察患者手术时间、术中出血量、输血量、住院时间,术前、术后髋关节HHS评分、PPMS评分、疼痛视觉模拟评分(visual analogue scale, VAS)及手术并发症发生情况。结果 20例均顺利完成手术,手术时间42.56~80.45(64.35±20.23)min,术中出血量976.46~2988.79(2001.34±986.45)ml,输血量452.14~1485.34(963.14±512.42)ml,住院时间7.50~18.50(14.23±4.82)d;20例术后HHS及PPMS评分均高于术前,术后VAS评分低于术前,差异均有统计学意义(P<0.01);术中未发生血管、神经损伤,术后随访期间未发生假体周围感染、松动、脱位、骨折不愈合及再骨折等并发症。结论全髋关节置换术后股骨假体周围骨折应用组配式股骨假体进行髋关节翻修治疗的近中期效果满意,且操作简单,可获得良好的骨折初始稳定性。
Objective To analyze the short and moderate term effect of modular femoral prosthesis in hip revision in the treatment of periprosthetic femoral fractures after total hip replacement. Methods The clinical data of 20 patients with periprosthetic femoral fractures undergoing total hip replacement in our hospital from June 2013 to June 2016 were retrospectively analyzed. The duration of operation, intraoperative blood loss, blood transfusion volume, length of hospitalization, as well as harris hip score (HHS), parker palmer mobility score (PPMS), and visual analogue scale (VAS) score before and after treatment and the occurrence of surgical complications were observed. Results All the 20 cases successfully underwent the surgery. The duration of operation was 42.56-80.45 (64.35±20.23) min, the intraoperative blood loss was 976.46-2988.79 (2001.34±986.45) ml, the blood transfusion volume was 452.14-1485.34 (963.14±512.42) ml, and the length of hospitalization was 7.50-18.50 (14.23±4.82) d. The HHS and PPMS scores of the 20 patients were higher than those before operation, and the postoperative VAS scores were lower than that before surgery. The differences were statistically significant ( P <0.01). No vascular injury or nerve injury was found during the operation. There were no complications such as periprosthetic infection, loosening, dislocation, nonunion or re-fracture during the follow-up. Conclusion The short and moderate term effect of modular femoral prosthesis in hip revision on periprosthetic femoral fractures after total hip replacement is satisfactory , and the operation is handy. Therefore, the initial stability of the fracture is good.
Clinical Misdiagnosis & Mistherapy
Arthroplasty, replacement, hip