Solution广泛多孔钛涂层长柄假体结合钢丝环扎固定治疗股骨头置换术后Vancouver B2型假体周围骨折的中期随访

背景：股骨头置换术后Vancouver B2型假体周围骨折多伴有假体松动，患者年龄大，并存疾病多，骨质条件差，围手术期处理及手术技术难度大，并发症发生率高。 目的：评价Solution广泛多孔钛涂层长柄假体结合钢丝环扎固定治疗股骨头置换术后Vancouver B2型假体周围骨折的中期疗效。 方法：回顾分析2008年1月至2010年12月我科收治的14例股骨头置换术后Vancouver B2型假体周围骨折患者的临床资料，其中男6例，女8例，年龄66-80岁，平均70.3岁。所有患者均采用骨折切开复位钢丝环扎固定结合Solution股骨柄进行翻修手术。末次随访时进行Harris髋关节评分（术前由于骨折未能进行Harris髋关节评分）；术前，术后3、6、12个月及末次随访时摄X线片，用于评价骨折复位及愈合，假体初始固定及中期生存情况。 结果：共16例患者，1例术后3年死于肺癌，1例失访，14例获得随访，随访时间3-5年，平均4.2年。末次随访时Harris评分88.7分。X线显示骨折复位，股骨柄超过骨折远端的固定长度超过5 cm，与股骨压配良好。骨折愈合时间3-6个月，平均（3.8＆#177;1.3）个月。末次随访时未见股骨柄松动、下沉。无感染、深静脉血栓形成和肺栓塞。 结论：Solution股骨柄结合钢丝环扎固定治疗股骨头置换术后Vancouver B2型假体周围骨折中期疗效好，其远期结果有待于进一步的随访。

Midterm follow-up of long handle prosthesis-Solution extensively titanium porous coated stem with wire cerclage in revision of Vancouver type-B2 periprosthetic femoral fractures after hemiarthroplasty

Background： Patients with Vancouver type-B2 periprosthetic femoral fractures after hemiarthroplasty often are elder with much more co-morbidities and poor bone condition. The perioperative management and surgical technique are very diffi-cult, and the incidence of complications is very high. Objective：The aim of the study is to evaluate the intermediate-term curative effect of long handle prosthesis-Solution exten-sively titanium porous coated stem with wire cerclage in revision of Vancouver type-B2 periprosthetic femoral fractures af-ter hemiarthroplasty. Methods：Clinical data of 14 patients with Vancouver type-B2 periprosthetic femoral fractures after hemiarthroplasty treated between January 2008 and December 2012 in our hospital were retrospectively analyzed. There were 6 males and 8 females, with a mean age 70.3 years （range from 66 to 80 years）. All of them received open reduction, internal fixation, and revision with Solution stem. Hip Harris score was assessed at the last follow-up after surgery. Radiographs were taken before sur-gery, 3, 6, 12 months after surgery and the last follow-up to assess the fracture restoration and healing, prosthesis initial fixa-tion and intermediate-term survival condition. Results：Sixteen patients, 1 case died of lung cancer 3 years after surgery, 1 case loss of follow-up, 14 cases were followed up 3-5 years, mean 4.2 years. Preoperative hip Harris score was not obtained because of fracture, and the mean Harris score was 88.7 at the last follow-up. Radiographs showed reduction of fracture was successfully achieved, the fixed length of the stem surpassing fracture line were more than 5 cm, and the femur was well pressed-fit well. The average healing time of＆amp;nbsp;fracture was （3.8＆#177;1.3） months （range, 3-6 months）. There were no loosening, subsidence of Solution stem at the last follow-up. No infection, deep vein thrombosis and pulmonary embolism occurred. Conclusions： The mid-term curative effect of the long handle prosthesis-Solution exte