人工髋关节置换后的股骨假体周围骨折

背景：随着人工髋关节置换的广泛应用以及相关研究的深入，更多继发性股骨假体周围骨折被报道。 目的：探讨人工髋关节置换后发生股骨假体周围骨折的原因、预防措施及骨折的分型治疗方法。 方法：回顾性研究人工髋关节置换后发生的股骨假体周围骨折的分型、治疗方法及相应临床疗效的临床资料，对相关文献资料趋势进行多层次探讨，依据Vancouver分型标准，分析各类型骨折及各种治疗方式的结果与并发症，明确不同骨折类型的治疗方法，建立客观有效的评估标准，为临床治疗提供参考。 结果与结论：人工髋关节置换后股骨假体周围骨折的与患者的年龄、基础疾病、骨质疏松和假体类型的选择等因素密切相关，Vancouver分型标准及治疗方案对临床治疗有指导意义，根据不同分型采用不同的治疗方法以促进骨折愈合，人工髋关节置换后股骨假体周围骨折的治疗方法多采用形状记忆合金环抱器、微创内固定系统、锁定加压钢板、异体皮质骨板、碳纤维板、打压植骨及翻修等固定，实际应用中常会有几种方式结合运用，对于B2和B3型骨折患者，应注意骨折周围、髓腔内外充分植骨。

Fractures around femoral prosthesis after artificial hip replacement

BACKGROUND:With the wide application and in-depth research of artificial hip joint, more secondary fractures around femoral prosthesis are reported. OBJECTIVE:To investigate the reasons, preventive measures, classification and treatment method of fractures around femoral prosthesis after artificial hip replacement. METHODS:The clinical data of the type classification, treatment method and clinical efficacy of fractures around femoral prosthesis after artificial hip replacement were retrospectively analyzed. The multi-level study was performed to investigate the trend of the relevant literatures. According to the Vancouver classification criteria, the various types of fractures and the results and complications of various treatment methods were analyzed, the treatment methods of different fractures were identified, and the effective and objective evaluation criteria were established to provide references for the clinical treatment. RESUTLS AND CONCLUSION:The fractures around femoral prosthesis after artificial hip replacement were closely related with the age of the patients, basic diseases, osteoporosis and selection of prosthesis type. The Vancouver classification criteria and treatment programs have guiding significance to the clinical efficacy. The fractures should be treated with different methods according to the different types in order to promote the fracture healing. The fractures around femoral prosthesis after artificial hip replacement were commonly treated with shape memory alloy embracing fixator, minimally invasive fixation system, locking compression plate, allograft cortical bone plates, carbon fiber, impaction bone grafting and renovation. In the practice application, various methods are often used in combination. For the patients with B2 and B3 type fractures, we should pay attention to the bone grafting around the fractures and the inner and outer medullary cavity.