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Cable-Ready® GTR 装置治疗合并骨质疏松的股骨假体周围骨折
Cable-Ready® GTR device for treating periprosthetic femoral fractures combined with osteoporosis
  
DOI:
中文关键词:  Cable-Ready® GTR 装置  股骨假体周围骨折  骨质疏松症
英文关键词:Cable-Ready® GTR device  Periprosthetic femoral fracture  Osteoporosis
基金项目:
作者单位
薛华明 马童 文涛 杨涛 薛龙 张颖川 王方兴 蔡珉巍 涂意辉*  
通讯作者:薛华明 马童 文涛 杨涛 薛龙 张颖川 王方兴 蔡珉巍 涂意辉*    
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中文摘要:
      目的 探讨Cable-Ready® GTR 装置治疗髋关节置换术后股骨假体周围骨折的可行性及疗效。方法 2012年5月-2013年12月起收治12例股骨假体周围骨折患者,均采用Cable-Ready® GTR 装置治疗。男7例,女5例,年龄62-78岁,平均70.2岁;10例为跌跤受伤,2例为车祸撞伤;假体周围骨折距初次髋关节置换手术的平均时间6月-120个月,平均16.5月;非骨水泥型假体9例,骨水泥型假体3例;初次全髋置换术为3例,半髋关节置换术为9例;按照Vancouver分型标准,A型3例,B1型7例,B2型2例;观察切口大小、手术时间、出血量、引流量和并发症。手术前、后采用Harris评分系统进行功能评定。结果 12例患者术中出血250-550 mL,平均375.3 mL,手术时间为98-150 min,平均142.6 min。全部病例术后随访52-71个月,平均60.8个月。12例术后随访骨折临床愈合时间为3-8月,平均为5.2月。末次随访Harris平均得分为88.9分(75-92分),优5例,良4例,可3例。术后1例高龄患者发生心功能衰竭,经内科保守治疗病情缓解。无一例出现下肢深静脉血栓(DVT)。所有患者未发生骨折再次移位,螺钉松动,内固定断裂,感染等并发症。结论 Cable-Ready® GTR 装置治疗股骨假体周围骨折操作简便,内固定效果确切,是一种可供选择的较好的治疗方式。
英文摘要:
      Objective To explore the feasibility and clinical effect of Cable-Ready® GTR device for periprosthetic femoral fractures combined with osteoporosis. Methods Between May 2012 and December 2013, twelve consecutive patients with periprosthetic femoral fracture were treated with Cable-Ready® GTR device. There were seven men and five women with an average age of 70.2 years (range 62 to 78 years) at the time of fracture. According to the injurious cause, 10 of them were fall injure and 2 was impact injure. The average period between original operation and periprosthetic fracture was 16.5 months (range 6 to 120 months). Nine prostheses were uncemented and 3 were cemented. Three fractures were around total hip arthroplasty and 9 were around hemiarthroplasty. According to Vancouver standard, there were 3 cases of type A, 7 cases of type B1, and 2 cases of type B2. Incision, surgical time, blood loss, drainage and complications were measured. The pre- and post operative hip function was evaluated by Harris hip score. Results The mean blood loss was 375.3 mL (range 250 to 550 mL). The mean time of operation was 142.6 min (range 98 to 150 min). The mean duration of follow-up was 60.8 months (range 52 to 71 months). Twelve fractures united in an average period of 5.2 months (range 3 to 8 months). At time of final follow-up, the mean Harris hip score was 88.9 (range 75 to 92). The overall outcome was excellent in 5 patients, good in 4 patients, fair in 3 patients. One elderly patient suffered heart failure, which was cured after medical conservative treatment. None had compilations of deep venous thrombosis, loss of reductions, screws loosening, plate break and infection. Conclusion Cable-Ready® GTR device is a good alternative for treating periprosthetic femoral fractures with obvious advantages of simple operation and reliable fixation.
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