Cable-Ready索绑系统配合长柄假体修复全髋关节置换后股骨假体周围骨折

背景：股骨假体周围骨折为全髋关节置换后的一种严重并发症，85%以上属于Vancouver B2、B3型骨折，手术难度较大。 目的：探讨全髋关节置换后发生Vancouver B2、B3型股骨假体周围骨折的患者采用Cable-Ready索绑系统配合生物型长柄假体治疗的临床效果和对关节功能恢复的影响。 方法：将2011年9月至2012年9月在黄冈市中心医院行全髋关节置换后发生Vancouver B2、B3型股骨假体周围骨折的患者60例作为研究对象，根据内固定方式的不同分为对照组和观察组，各30例。对照组患者采用普通钢丝环扎内固定结合生物型长柄假体的治疗方式，观察组患者采用Cable-Ready索绑系统内固定结合生物型长柄假体的治疗方式。 结果与结论：观察组患者平均手术时间、住院时间和骨折愈合时间均比对照组短，且术中出血量也比对照组少；随访1年后，观察组患者髋关节Harris总分高于治疗前(t=3.174 9，P=0.002 6)，也明显高于对照组(t=2.479 8，P=0.015 4)；观察组患者髋关节Harris总分的优良率明显高于对照组(χ2=11.294 5，P=0.002 6)；观察组患者置换后并发症的总发生率明显低于对照组(χ2=8.139 7，P=0.042)。说明采用Cable-Ready索绑系统结合生物型长柄假体治疗全髋关节置换后发生的Vancouver B2、B3型股骨假体周围骨折，患者损伤较小，置换后并发症较少，置换后髋关节功能恢复较好。中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Cable-Ready fast system combined with long-stem prosthesis for periprosthetic femoral fractures after total hip arthroplasty

BACKGROUND:Periprosthetic femoral fracture is a severe complication after total hip arthroplasty. More than 85% belongs to Vancouver B2 and B3 fractures, and the operation is difficult. OBJECTIVE:To explore the clinical effect of Cable-Ready fast system and biotype long-stem prosthesis and its effect on the recovery of joint function in patients with Vancouver B2 and B3 type periprosthetic femoral fractures after total hip arthroplasty. METHODS:A total of 60 patients receiving total hip arthroplasty suffered from Vancouver B2 and B3 type periprosthetic femoral fractures in the Huanggang Central Hospital from September 2011 to September 2012. They were equally divided into control and observation groups according to different fixation methods. Patients in the control group were treated by ordinary steel wire cerclage fixation combined with uncemented long-stem prosthesis; those in the observation group were treated by Cable-Ready fast system combined with fast uncemented long-stem prosthesis. RESULTS AND CONCLUSION:The average operation time, the time of hospitalization and fracture healing time were shorter in the observation group than in the control group. Moreover, the intraoperative blood loss was less in the observation group than in the control group. After 1 year of follow-up, Harris hip score was higher in the observation group compared with pre-treatment (t=3.174 9, P=0.002 6), and significantly higher than the control group (t=2.479 8, i0.015 4). The excellent and good rate of Harris hip score was significantly higher in the  observation group than in the control group (χ2=11.294 5, P=0.002 6). The total incidence of complications was significantly lower in the observation group than in the control group (χ2=8.139 7, P=0.04 2). These data indicate that Cable-Ready fast system combined with uncemented long-stem prosthesis in the treatment of Vancouver B2 and B3 periprosthetic femoral fractures after total hip arthroplasty has small injury, less postoperative complications and better recovery of hip function after operation.