摘要
目的：随着人工髋关节置换的广泛开展及翻修手术的不断增加，假体周围骨折的发生明显增多，而这类骨折处理较为复杂困难；拟探讨人工髋关节置换术后股骨假体周围骨折采用切开复位记忆合金环抱器内固定治疗效果。
方法：①对象：来自2001-03/2005-08 广西医科大学第一附属医院创伤骨科共收治人工髋关节置换术后股骨假体周围骨折患者8例，男3例，女5例，年龄35~80岁。骨折发生于原髋关节置换术后3个月~7年，按Vancouver骨折分型B1型7例，B2型1例。②治疗：均采用切开复位形状记忆合金锯齿臂环抱内固定器内固定治疗，其中1例（B2型）同时行骨水泥长柄假体翻修。③评估：术后随访时观察X射线片、关节活动度及材料与宿主不良反应。
结果：8例患者均得到1~4年随访。1年后检查髋关节活动度屈曲均大于100°，经X射线检查骨折均愈合，无感染、骨折不愈合、内固定断裂等并发症发生。
结论：对于人工髋关节置换术后股骨假体周围骨折, 形状记忆合金锯齿臂环抱内固定器具有安装方便、固定可靠、经济实用的优点，是一种可供选择的良好治疗方法。
关键词：关节成形术，置换，髋；假体周围骨折；记忆合金；组织构建

白鹤，赵劲民，杨志，苏伟.人工髋关节置换术后股骨假体周围骨折 [J].中国组织工程研究与临床康复，2008，12(9):1662-1664
[www.zglckf.com/zglckf/ejournal/upfiles/08-9/9k-1662(ps).pdf]

Periprosthetic femoral fracture after hip replacement

Abstract
AIM: Periprosthetic fractures around hip replacement are increased and difficult to treat. This study explored the treatment outcome of shape memory alloy sawtooth-arm embracing fixator for periprosthetic femoral fracture after hip replacement.　
METHODS: ①Eight cases of periprosthetic femoral fracture after hip replacement admitted in Department of Orthopedics and Traumatology, First Affiliated Hospital of Guangxi Medical University from March 2001 to August 2005 were selected, including 3 males and 5 females aged 35-80 years. These periprosthetic fractures occurred 3 months to 7 years after hip replacement. According to classification to periprosthetic fracture of Vancouver, there were 7 cases of type B1 and 1 case of type B2. ②All 8 cases were treated with shape memory alloy sawtooth-arm embracing fixator, and 1 case (type B2) was treated with long-shaft prosthesis revision at the same time. ③X-ray films, joint range of motion, and adverse effect between material and host were observed during follow-up.
RESULTS: All 8 cases were followed up for 1-4 years. Hip joint range of motion was > 100° by flexion one year after surgery. All fractures healed with no complication such as infection, nonunion or fixator breakage by X-ray.
CONCLUSION: Shape memory alloy sawtooth-arm embracing fixator is a reliable, practical and economical alternative for periprosthetic femoral fracture after hip replacement.

Bai H, Zhao JM, Yang Z, Su W. Periprosthetic femoral fracture after hip replacement.Zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu 2008;12(9):1662-1664(China) [www.zglckf.com/zglckf/ejournal/upfiles/08-9/9k-1662(ps).pdf]