假体周围骨折专题讲座.doc

【专题文献】之人工髋关节置换 全髋翻修讲座之一：全髋关节置换疼痛的评估By: 宋兵乙全髋翻修讲座之二：髋关节翻修术中内植物的取出By: 宋兵乙全髋翻修讲座之三：髋关节翻修术中髋臼失败的重建和翻修By: 宋兵乙全髋翻修讲座之四：髋关节翻修术中股骨失败的重建和翻修By: 宋兵乙全髋翻修讲座之五：全髋关节置换术后髋关节脱位的处理By: 飘洋过海全髋翻修讲座之六：全髋关节置换术假体周围感染的处理By: shiitake全髋翻修讲座之七：下肢假体周围骨折的处理By：宋兵乙MINI-SYMPOSIUM: REVISION HIP SURGERY小讲座：髋关节翻修术之七(vii) Management of periprosthetic fractures in the lower limb(vii) 下肢假体周围骨折的处理Panos Makrides;Harpal Singh Uppal;Steve KriklerAbstractThe incidence of periprosthetic fractures is rising significantly as more replacement arthroplasties are performed. They are a potentially devastating complication associated with high morbidity and mortality. Their management is a sub-specialty in itself. This article outlines the principles of the management of periprosthetic fractures of the lower limb.Keywords bone graft; internal fixation; peri-prosthetic fracture摘要当实施了更多的关节置换手术，假体周围骨折的发生正在显著增加。这是潜在的毁灭性的并发症，伴随着很高的发病率和死亡率。其处理本质上是一个亚专业。本文列举了下肢假体周围骨折的处理原则。关键词：骨移植，内固定，假体周围骨折。IntroductionAn aging population with higher standards of living has led to a steady increase in replacement arthroplasties in developed countries as recorded by the Scandinavian, Australian, UK and Mayo Clinic Registers. The positive outcome of an otherwise successful procedure can be compromised by a periprosthetic fracture (PPF). It is a major problem, associated with high rates of morbidity and mortality.1,2 The prevalence is difficult to ascertain but the consensus is that they are increasing both numerically and in complexity. In 2006 Lindahl et al. reported the cumulative incidence of periprosthetic hip fractures as 0.4%.3 According to the Swedish Hip Registry, PPF is the third commonest reason for revision arthroplasty, after aseptic loosening and dislocation.4 Periprosthetic fractures around a total knee arthroplasty are less common but equally important. They are more common in the distal femur (0.3e2.5%) compared with the proximal tibia (0.39% to 0.5%).引言：老年人群，由于更高生活标准，导致发达国家的人工关节置换稳步上升，如同斯堪的那维亚