肱骨近端锁定钢板固定B1和B2型股骨假体周围骨折

Proximal humeral internal locked system plates for internal fixation of type B1 and B2 periprosthetic femoral fractures

摘要:

［目的］评价肱骨近端锁定钢板（proximal humeral internal locked system plate, PHILOS）固定 Vancouver B1 和 B2 型股骨假体周围骨折的临床疗效。［方法］ 2017 年 9 月—2019 年 1 月采用 PHILOS 固定 Vancouver B1 和 B2 型股骨假体周围骨折 7 例，其中 B1 型 5 例，B2 型 2 例；男 5 例，女 2 例；年龄 57~86 岁，平均（71.71±9.11）岁。［结果］本组 7 例患者均顺利完成手术，术后无切口感染以及深静脉血栓形成等严重并发症。7 例患者随访 12～24 个月，平均（17.29±3.86）个月。随术后时间推移，患者的 Harris 评分显著增加 （P<0.05）。末次随访时，5 例能够自由行走，2 例需要借助步行器完全负重行走。影像方面，所有患者股骨假体周围骨折均愈合，股骨假体无松动，PHILOS 无失效。［结论］ PHILOS 应用在 Vancouver B1 和 B2 型股骨假体周围骨折的治疗中，其手术更简单，医疗费用支出更少。

Abstract:

[Objective] To evaluate the clinical efficacy of proximal humeral internal locked system plates (PHILOS) for internal fixa- tion of Vancouver type B1 and B2 periprosthetic femoral fractures. [Methods] From September 2017 to January 2019, 7 patients had peri- prosthetic femoral fractures fixated with PHILOS plate, including 5 cases of Vancouver type B1 and 2 cases of type B2. Of them, 5 males and 2 females aged 57 to 86 years with an average of (71.71±9.11) years. [Results] All the 7 patients were successfully operated on without serious complications, such as postoperative incision infection and deep venous thrombosis. The patients were followed up for 12~24 months, with an average of (17.29±3.86) months. The Harris scores increased significantly over time postoperatively (P＜0.05) . At the latest follow-up, 5 patients were able to walk freely, while the remaining 2 patients resumed full weight-bearing walking with the aid of a walker. Radiographically, all patients had periprosthetic fractures healed, without loosening of the femoral prosthesis, and with no failure of PHI- LOS plate. [Conclusion] The PHILOS plate used for the treatment of Vancouver type B1 and B2 periprosthetic femoral fractures has bene- fits of simplifying surgical operation and decreasing medical cost.