目的：探讨全膝关节置换术后股骨假体周围骨折的治疗方法及疗效。方法：2007年7月！2012年6月全膝关节置换术后 Insall I／Ⅱ型股骨髁上骨折患者21例，其中18例获得随访，随访时间12～26个月（平均19．8个月）。18例患者中，5例（I 型1例、ⅡA 型2例、ⅡB 型2例）采用非手术治疗，13例（I 型1例、ⅡA 型2例、ⅡB 型10例）采用切开复位锁定钢板内固定术治疗。骨折后6个月，测量18例患者的膝关节活动范围、肢体力线，并采用美国特种外科医院膝关节评分（hospital for special surgery knee score，HSS）评定患者的膝关节功能。结果：18例患者的骨折均愈合，非手术患者的平均 HSS 评分为75．6分，手术治疗患者的平均 HSS 评分为85．08分。结论：采用切开复位锁定钢板内固定术治疗全膝关节置换术后股骨假体周围骨折的疗效较好。%Objective:To investigate the treatment methods and efficacy of periprosthetic femoral fractures after total knee ar-throplasty.Methods:A total of 21 patients with periprosthetic femoral fractures (Insall I or II)after total knee arthroplasty from 2007 Jul to 2012 Jun were enrolled.There were 18 patients were followed for 12-26 monthes,with an average time of 19.8 months.Among them,5 cases (Insall I 1,ⅡA 2,ⅡB 2)were treated conservatively,while the other 13 cases (Insall I 1,ⅡA 2,ⅡB 10)were treated with open reduction and internal fixation with a locking-plate.At 6 monthes after fracture,the range of motion,physical line of force were measured,and the knee function of all patients were assessed by hospital for special surgery knee score (HSS).Results:The average HSS score was 75.6 in 5 patients treated conservatively,and 85.08 in 13 patients un-dergone operation.Conclusions:Open reduction and fixation inside with locking-plate is curative for periprosthetic femoral frac-tures after total knee arthroplasty.
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