インプラント挿入後における大腿骨骨幹部骨折の治療経験

抄録

Aim;
The purpose of this study was to assess whether plate and cable-wire can be used in the treatment of periprosthetic femoral shaft fractures.
Patient and Methods;
We treated 7 cases of 6 patients (all females) who exhibited periprosthetic femoral shaft fractures. The age of the patients ranged from 73 to 94 years (average; 79.1 years). The prostheses that had been inserted before were 6 components of THA or BEA (3 were cemented, 3 non-cemented), and one intramedullar nail. The case involving the intramedullar nail, not with standing, the fractures were categorized by Johansson's classification: 4 cases were type I fracture, and 2 were type III. All cases were treated by open reduction, using the Dall-Miles Cable Grip System (Howmedica product) in 5 cases and the Cable-Ready Cable Grip System (Zimmer product) in 2, and were clinically and radiologically assessed after the open reduction.
Results;
Regardless of not using external fixation, refractures did not occurr in any of the cases. Except for 2 patients with severe dementia or hemiparesis, the initiation of weight-bearing after open reduction was relatively early, ranging from 14 to 40 days (average; 26.2 days).
Conclusion;
It was concluded that plate and cable-wire can be used for the treatment of periprosthetic femoral shaft fractures.