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首页> 外文期刊>Open Journal of Urology >Intraoperative Periprosthetic Femoral Fractures Related to Austin Moore Hemiarthroplasty—A Retrospective Review of 365 Patients
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Intraoperative Periprosthetic Femoral Fractures Related to Austin Moore Hemiarthroplasty—A Retrospective Review of 365 Patients

机译：奥斯汀·摩尔假体成形术相关的术中股骨周围假体骨折— 365例患者的回顾性回顾

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Intraoperative periprosthetic femoral fractures (IPFF) have been studied extensively for total hip arthroplasties, but not for hemiarthroplasties. Recent series in the literature show an IPFF rate for hemiarthroplasties ranging from 0% to 14%. The present study was designed to determine the prevalence and outcome after IPFF during non-cemented hemiarthroplasty. In addition, the surgical step at higher risk to produce these fractures was evaluated in an attempt to identify strategies that could minimize the prevalence of this complication. We performed an observational study of 365 consecutive patients undergoing and Austin-Moore hemiarthroplasty from 2005 to 2006 at our institution. The institutional IPFF rate was 6.8% (twenty-five out of 365). The moment at which the fracture was detected was collected: 1) intraoperatively and 2) in the postoperative radiological control. The surgical step in which the fracture occurred was collected: 1) neck osteotomy, 2) broaching, 3) prosthesis introduction, and 4) reduction. Results were compared to a control group according to blood transfusion rate, mortality rate and revision surgery rate. The fractures were detected during the surgery in twenty cases (80%); for the five remaining cases the fracture was only detected in the postoperative radiology. For those detected during the surgery, the two most common manouvers in which the fracture occurred was hip reduction (10 cases) and prosthesis introduction (7 cases). The blood transfusion rate, first-month mortality rate and revision surgery rate showed no statistical difference between the two groups (p = 0.3). In the present series, most of IPFF during Austin-Moore hemiarthroplasty implantation, occurred during arthroplasty reduction. Difficulties during this step should lead the surgeon to reconsider if technical mistakes are present and can be solved. However, if fracture occurs, adequate treatment of IPFF should provide satisfactory results without increasing blood transfusion needs, mortality or revision surgery.
机译：术中股骨假体周围骨折（IPFF）已被广泛研究用于全髋关节置换术，但不用于半髋关节置换术。文献中的最新系列显示半髋关节置换术的IPFF率为0％至14％。本研究旨在确定非骨水泥性半髋置换术中IPFF的患病率和结局。此外，评估了发生这些骨折的风险较高的外科手术步骤，以试图确定可将这种并发症的患病率降至最低的策略。我们从2005年至2006年在我们机构对365名连续进行Austin-Moore半髋关节置换术的患者进行了观察性研究。机构的IPFF率为6.8％（365个中有25个）。收集发现骨折的时间：1）术中和2）术后放射学控制。收集发生骨折的外科手术步骤：1）截骨术; 2）拉削; 3）植入假体; 4）复位。根据输血率，死亡率和翻修手术率将结果与对照组进行比较。手术中发现骨折20例（80％）;对于剩下的五种情况，仅在术后放射学中才发现骨折。对于在手术中发现的那些，发生骨折的两种最常见的操作是髋关节复位术（10例）和假体植入术（7例）。两组之间的输血率，第一个月死亡率和翻修手术率无统计学差异（p = 0.3）。在本系列中，大部分奥斯汀-摩尔半髋关节置换术中的IPFF发生在置换术中。如果存在技术错误并且可以解决，则此步骤中的困难将导致外科医生重新考虑。但是，如果发生骨折，对IPFF的充分治疗应提供令人满意的结果，而不会增加输血需求，死亡率或翻修手术。

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