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这里我将全文翻译了一下，恳请战友们对我翻译的文字给指导。
股骨假体周围骨折当前的处理现状
Eleftherios Tsiridis, a, , Steve Kriklera and Peter V. Giannoudisa
aAcademic Department of Trauma & Orthopaedics, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK
Available online 1 May 2007.
Periprosthetic fractures are technically demanding to treat, as they require the skills of trauma surgery as well as those of revision arthroplasty.3, 8, 10 and 20 Lindahl et al.,10 reporting on 1049 periprosthetic femoral fractures, found that the annual incidence varied between 0.045% and 0.13% for all total hip arthroplasties (THA) performed in Sweden, that the accumulated incidence for the primary hip arthroplasties was 0.4% and that for the revision arthroplasties was 2.1%.
假体周围骨折的治疗在技术上是有着要求的，即需要有创伤手术的技巧，又必须对关节置换翻修很熟练 [3，8，10，20] 。Lindahl等[10]报道了1049例假体周围骨折，他们发现所有在瑞典进行的全髋关节置换中，每年的发生率在0.045%至0.13%之间变化。初次全髋关节置换累计发生率为0.4%，翻修的全髋关节则为2.1%。
The principle underlying the surgical management of periprosthetic fractures is that consideration needs to be given to the fracture location, the stability of the components and the quality of the underlying bone stock.3 Currently the Vancouver classification is probably the most widely used classification system addressing all these issues.1 When the stem is stable, open or closed reduction and internal fixation may be undertaken. Dynamic compression plates (DCP) and dynamic condylar screw (DCS) plates have been used with good results.8 and 22 Plates combining cables and screws allow fixation with cerclage cable around the prosthesis.19 These plates have technical advantages but there are several biomechanical considerations and drawbacks, therefore, they should be used with caution.19 Recently, percutaneous, so-called biological plate fixation has been advocated with favourable results for both periprosthetic fractures around hip15 and knee arthroplasties.16 However, some fracture configurations may affect the outcome of internal fixation even when the stem is stable. Transverse fractures at the tip of the stem are very difficult to treat with plates alone, and in these cases revision of the stem, despite it being stable, may be preferred.
对假体周围骨折进行手术治疗的原则，必须考虑到骨折部位、假体的稳定性以及支撑骨干的骨质量等问题[3] 。当前Vancouver分型可能是阐明了这些问题且应用最为广泛的一种分型系统[1] 。当股骨柄稳定时，开放或闭合复位内固定是可以考虑的。动力加压钢板）（DCP）和动力髁螺钉（DCS）已经被应用并取得了良好的效果[8，22] 。钢板联合钢缆和螺钉，允许在假体周围环扎钢缆进行固定[19]，这种钢板有着技术上的优势，但这在生物力学上存在一些顾虑和缺陷，因此，其应用应该谨慎[19] 。最近经皮的，所谓的生物学钢板固定，由于其对髋关节[15] 和膝关节置换[16] 后假体周围骨折都有着良好的结果而被人们所提倡。然而，有些骨折类型，甚至在股骨柄稳定的情况下，仍可能影响内固定的结果。股骨柄远端横断骨折应用单纯的钢板进行处理是很困难的，在这种情况下，对股骨柄进行翻修，尽管它是稳定的，可能更可取。
In treating a periprosthetic fracture with a revision arthroplasty, whenever possible cortical perforations and femoral fractures should be bypassed by at least 2 femoral diameters.6 Most reports in the literature discuss the use of long-stem cemented revisions but more recently, the use of uncemented prostheses has been advocated.8 However, 5–10 cm of intact diaphysis should be present to secure stable distal fixation.12 and 13
在关节置换翻修后的假体周围骨折的治疗中，在任何可能的情况下，皮质钻孔与股骨骨折都应隔开至少2个股骨直径[6] 。文献中大多数的报道都讨论应用长柄骨水泥假体进行翻修，但是近年来，也有人提倡应用非骨水泥假体[8] 。然而，这必须存在5-10 cm完整的骨干，以保证远端固定的牢固性[12，13] 。
Cortical onlay grafts, first described for the treatment of femoral periprosthetic fractures by Chandler and Tigges,2 are an attractive option because they combine fixation with the potential to restore the bone stock and increase cortical strength, as shown in several studies. However availability, disease transmission and incomplete incorporation to host bone are still some of the downsides of their use.
皮质骨加盖移植，Chandler and Tigges[2]最先描述其用于治疗股骨假体周围骨折，这是一个很被人看好的选择，因为这一方法将固定和修复骨干增加皮质骨强度的可能性结合了起来，这在几项研究中得到了证实。然而，其有效性、疾病的传染和不能与宿主骨质完全结合等仍然是其应用中的不足之处。
Impaction grafting with long cemented femoral prostheses, bypassing the most distal fracture line, together with structural cortical grafts and or plates, has also been attempted with encouraging results. The technique is however demanding and allograft availability may be a problem.18 and 21
应用长柄股骨骨水泥假体的同时进行嵌入式植骨，通过避开最远端的骨折线，结合应用结构性皮质骨植骨和/或钢板，这一努力也得到了令人鼓舞的结果。然而，其技术上的要求和同种异体骨移植的有效性可能还存在问题[18，21] 。
For patients unfit for long revision procedures, and when the cement mantle is well preserved, especially in the peritrochanteric region, cement-in-cement revision to a longer stem, following adequate preparation of the old mantle to promote bonding between new and old cement, is possible.9 Unpublished data and personal communication with the Hip Unit of the Royal Devon and Exeter Hospital have provided us with encouraging results in this group of patients. When there is massive bone loss, however, proximal femoral replacement, either with a massive structural prosthesis5 and 14 or with proximal femoral allograft replacement, is recommended.4 and 11
由于患者不适宜进行时间较长的翻修手术，当其骨水泥壳套得以完整保存的时候，尤其是在粗隆周围区域，对老的壳套进行足够的准备工作，以促进新老骨水泥之间的结合后，进行更长柄的骨水泥对骨水泥翻修也是可能的[9] 。从英国得文暨艾克斯特皇家医院髋关节科（部门）提供给我们的一些未发表的数据和个人的信息来看，这一组患者有着令人鼓舞的结果。当存在大块骨丢失时，则推荐[4，11]应用股骨近端置换，伴有大块结构的假体[5，14]和/或伴有股骨近端同种异体骨移植的置换。
Fractures around knee arthroplasties should also be treated according to prosthesis stability. If the prosthesis is unstable then revision is necessary to a stemmed device, cemented or uncemented, in order to internally brace the fracture. In the case of stable implants, both supracondylar nails and distal condylar locking or standard plates have been used with variable success. Clinical and biomechanical data are scarce, making it difficult to offer firm guidance in the management of these fractures.16 and 17
膝关节置换后周围骨折的处理也同样应该考虑到假体的稳定性。如果假体是不稳定的，为了对骨折起到内部支撑的作用，则必须应用骨水泥或非骨水泥的带柄假体进行翻修。在植入物稳定的情况下，髁上钉和髁部远端锁定或标准钢板都已有应用，并取得了一些有差异的成功。由于缺乏临床和生物力学资料，对这一骨折的处理[16，17] ，还难以提出明确的指导方案。
It is likely that in the future, periprosthetic femoral fractures will become more common. Surgeons with fellowship training in trauma and hip revision arthroplasty should undertake the care of these fractures. In countries with a national joint registry, we should be able to identify these fractures, record treatment methods and publish the outcomes. Overall the best management of these fractures would be prevention, which depends on the vigilant follow-up of every joint arthroplasty so that imminent fractures can be identified and treated early.7
将来很有可能的是，股骨假体周围骨折会更加常见。在创伤和髋关节置换翻修方面都有着良好训练的外科医生从事这一骨折的相关工作。在有全国关节登记制度的国家，我们将会找出这些骨折，登记其治疗方法，并对其结果进行发表。总的说来，处理这类骨折最好的方法可能是预防，通过对每一关节置换进行有意识随访，以识别即将要发生的骨折，并进行早期处理[7] 。
References
1 O.H. Brady, D.S. Garbuz, B.A. Masri and C.P. Duncan, The reliability and validity of the Vancouver classification of femoral fractures after hip replacement, J Arthroplasty 15 (2000), pp. 59–62. Abstract | PDF (4005 K) | View Record in Scopus | Cited By in Scopus
2 H.P. Chandler and R.G. Tigges, The role of allografts in the treatment of periprosthetic femoral fractures, Instr Course Lect 47 (1998), pp. 257–264. View Record in Scopus | Cited By in Scopus
3 D.S. Garbuz, B.A. Masri and C.P. Duncan, Periprosthetic fractures of the femur: principles of prevention and management, Instr Course Lect 47 (1998), pp. 237–242. View Record in Scopus | Cited By in Scopus
4 F.S. Haddad, D.S. Garbuz, B.A. Masri and C.P. Duncan, Structural proximal femoral allografts for failed total hip replacements: a minimum review of five years, J Bone Joint Surg Br 82 (2000), pp. 830–836. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus
5 G.R. Klein, J. Parvizi and V. Rapuri et al., Proximal femoral replacement for the treatment of periprosthetic fractures, J Bone Joint Surg Am 87 (2005), pp. 1777–1781. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus
6 J.E. Larson, E.Y. Chao and R.H. Fitzgerald, Bypassing femoral cortical defects with cemented intramedullary stems, J Orthop Res 9 (1991), pp. 414–421. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus
7 C.J. Lavernia, Cost-effectiveness of early surgical intervention in silent osteolysis, J Arthroplasty 13 (1998), pp. 277–279. SummaryPlus | Full Text + Links | PDF (255 K) | View Record in Scopus | Cited By in Scopus
8 D.G. Lewallen and D.J. Berry, Periprosthetic fracture of the femur after total hip arthroplasty: treatment and results to date, Instr Course Lect 47 (1998), pp. 243–249. View Record in Scopus | Cited By in Scopus
9 J.R. Lieberman, B.H. Moeckel and B.G. Evans et al., Cement-within-cement revision hip arthroplasty, J Bone Joint Surg Br 75 (1993), pp. 869–871. View Record in Scopus | Cited By in Scopus
10 H. Lindahl, H. Malchau, P. Herberts and G. Garellick, Periprosthetic femoral fractures classification and demographics of 1049 periprosthetic femoral fractures from the Swedish National Hip Arthroplasty Register, J Arthroplasty 20 (2005), pp. 857–865. SummaryPlus | Full Text + Links | PDF (165 K) | View Record in Scopus | Cited By in Scopus
11 A.C. Maury, A. Pressman and B. Cayen et al., Proximal femoral allograft treatment of Vancouver type-B3 periprosthetic femoral fractures after total hip arthroplasty, J Bone Joint Surg Am 88 (2006), pp. 953–958. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus
12 S. Mulay, T. Hassan, S. Birtwistle and R. Power, Management of types B2 and B3 femoral periprosthetic fractures by a tapered, fluted, and distally fixed stem, J Arthroplasty 20 (2005), pp. 751–756. SummaryPlus | Full Text + Links | PDF (158 K) | View Record in Scopus | Cited By in Scopus
13 K. O'Shea, J.F. Quinlan and S. Kutty et al., The use of uncemented extensively porous-coated femoral components in the management of Vancouver B2 and B3 periprosthetic femoral fractures, J Bone Joint Surg Br 87 (2005), pp. 1617–1621. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus
14 J. Parvizi, V.R. Rapuri and J.J. Purtill et al., Treatment protocol for proximal femoral periprosthetic fractures, J Bone Joint Surg Am 86-A (2004) (Suppl 2), pp. 8–16.
15 W.M. Ricci, B.R. Bolhofner and T. Loftus et al., Indirect reduction and plate fixation, without grafting, for periprosthetic femoral shaft fractures about a stable intramedullary implant, J Bone Joint Surg Am 87 (2005), pp. 2240–2245. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus
16 W.M. Ricci, T. Loftus, C. Cox and J. Borrelli, Locked plates combined with minimally invasive insertion technique for the treatment of periprosthetic supracondylar femur fractures above a total knee arthroplasty, J Orthop Trauma 20 (2006), pp. 190–196. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus
17 K. Srinivasan, D.A. Macdonald, C.C. Tzioupis and P.V. Giannoudis, Role of long stem revision knee prosthesis in periprosthetic and complex distal femoral fractures: a review of eight patients, Injury 36 (2005), pp. 1094–1102. SummaryPlus | Full Text + Links | PDF (453 K) | View Record in Scopus | Cited By in Scopus
18 E. Tsiridis and G.A. Gie, Mal-united femoral fractures adjacent to loose total hip arthroplasties. Salvage with impaction grafting. A case report, Injury 33 (2002), pp. 81–83. SummaryPlus | Full Text + Links | PDF (239 K) | View Record in Scopus | Cited By in Scopus
19 E. Tsiridis, F.S. Haddad and G.A. Gie, Dall-Miles plates for periprosthetic femoral fractures A critical review of 16 cases, Injury 34 (2003), pp. 107–110. SummaryPlus | Full Text + Links | PDF (92 K) | View Record in Scopus | Cited By in Scopus
20 E. Tsiridis, F.S. Haddad and G.A. Gie, The management of periprosthetic femoral fractures around hip replacements, Injury 34 (2003), pp. 95–105. SummaryPlus | Full Text + Links | PDF (227 K) | View Record in Scopus | Cited By in Scopus
21 E. Tsiridis, A.A. Narvani and F.S. Haddad et al., Impaction femoral allografting and cemented revision for periprosthetic femoral fractures, J Bone Joint Surg Br 86 (2004), pp. 1124–1132. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus
22 E. Tsiridis, A.A. Narvani, J.A. Timperley and G.A. Gie, Dynamic compression plates for Vancouver type B periprosthetic femoral fractures: a 3-year follow-up of 18 cases, Acta Orthop 76 (2005), pp. 531–537. View Record in Scopus | Cited By in Scopus
Corresponding author. Tel.: +44 113 20 66460; fax: +44 113 2
3、
全髋关节置换股骨假体周围骨折的流行病学
Hans Lindahl , a,
aDepartment of Orthopaedics, Institute of Surgical Sciences, Sahlgrenska University Hospital, Göteborg University, S-413 45 Gothenburg, Sweden
Accepted 27 February 2007. Available online 2 May 2007.
Summary
Periprosthetic femoral fractures can be classified as intraoperative and postoperative fractures. The intraoperative fractures mostly occur during the insertion of the femoral stem.
Depending on the fixation method used, differences in the incidence of intraoperative fractures have been reported. An increase of intraoperative fractures is reported with the introduction of uncemented stems and this is often a consequence of the effort to obtain a sufficient press-fit to gain initial stem stability. In revision surgery an even higher incidence has been reported, ranging between 3.6% and 20.9% when cemented or uncemented prostheses are used, respectively. This review article reports on the prevalence of periprosthetic femoral fractures around a total hip replacement.
Keywords: Total hip replacement; Cemented; Uncemented; Femur; Fracture
摘要
股骨假体周围骨折可分为术中和术后骨折两类，术中骨折主要发生在插入股骨柄的时候。已有报道，按照应用的固定方法，其术中骨折的发生率也不一样。据报道，非骨水泥柄的打入会增加术中骨折的发生率，通常这是为了努力达到充分的紧压贴合，以获得股骨柄的初始稳定的结果。翻修手术中报道的发生率更高，当应用骨水泥或非骨水泥假体时，其范围分别在3.6% 至20.9%之间。这篇综述就对全髋关节置换股骨假体周围骨折的发病率作一报告。
关键词：全髋关节置换；骨水泥；非骨水泥；股骨；骨折
我想要全文
谢谢你！YNCHAOZHANG@GMAIL.COM
4、
股骨假体周围骨折的危险因素
John Franklina, , and Henrik Malchaub
aMassachusetts General Hospital, Boston, MA, United States
bDepartment of Orthopaedics, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, GRJ 1126, Boston, MA 02114, United States
Accepted 27 February 2007. Available online 30 April 2007.
Summary
Periprosthetic femur fractures are associated with high patient morbidity and are difficult reconstructive challenges. Early identification and appropriate intervention are caritical to prevent this complication. Studies varying from case reports to national arthroplasty registry databases have demonstrated that certain factors are associated with an increased risk of fracture. These include trauma, patient-specific problems, and technical issues related to the hip replacement itself. Recent evidence from large registries has shown that the key to prevention of periprosthetic femur fractures is routine follow-up with radiographic studies.
Keywords: Total hip arthroplasty; Periprosthetic fracture; Risk factors; Prevention
摘要
股骨假体周围骨折有着较高的发病率，且因其难于重建而具有挑战性。早期发现，并采取适当的干预措施对于预防这一并发症时至关重要的。包括病例报告和国家关节置换登记数据库在内的各种研究结果显示，某些因素与增加骨折的风险存在相关性。这包括创伤、患者特异性的问题，以及和全髋关节置换本身相关的技术问题。最近从登记的大样本的证据来看，预防股骨假体周围骨折的关键在于常规的X线随访研究。
关键词：全髋关节置换术；假体周围骨折；危险因素；预防
非常感谢楼主的热心。最近我科连续收治了2例半髋假体周围骨折的病例，均行手术治疗。正好楼主有这方面的资料。非常渴望能够获得一份。
x11h22m33@126.com
5、
股骨假体周围骨折的分型
T.M. Ninana, M.L. Costab and S.J. Kriklera, ,
aDepartment of Trauma and Orthopaedic Surgery, University Hospital Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, United Kingdom
bUniversity of Warwick, Coventry, CV4 7AL, United Kingdom
Accepted 20 February 2007. Available online 16 May 2007.
Summary
Classification systems for fractures of the femur with a prosthetic hip in situ are diverse and complex. Most of them are based on the site of the fracture, which is not the most important differentiating factor in treatment planning. The Coventry classification system groups the periprosthetic fractures into ‘happy hips’ and ‘unhappy hips’ based on whether or not the stem is loose. In ‘happy’ hips, treatment only needs to address the fracture itself, unless the fixation has been compromised by the fracture. In the ‘unhappy hips’, revision of the prosthesis is recommended.
Keywords: Periprosthetic fractures; Coventry classification
摘要
带有髋关节假体的股骨骨折的分型系统多种多样，且很复杂。其中大多数都是根据骨折的位置而分的，其实，这在治疗计划中并不是最重要的判别因素。Coventry分型系统根据股骨柄是否松动，将假体周围骨折分成“幸运的髋关节”和“不幸运的髋关节”两组。在“不幸运的髋关节”中，推荐进行假体翻修。
关键词：假体周围骨折；Coventry分型
6、
股骨假体周围骨折内固定和植入物选择的原则
Peter V. Giannoudis , a, , Nikolaos K. Kanakarisa and Eleftherios Tsiridisa
aDepartment of Trauma & Orthopaedic Surgery, Academic Unit, School of Medicine, University of Leeds, Clarendon Wing, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, United Kingdom
Accepted 27 February 2007. Available online 30 April 2007.
Summary
Periprosthetic femoral fractures (PFF) are increasing as a result of changes in population demographics and the increase in the number of total hip replacements performed. The overall incidence has been reported to range from 0.1% to 6% of all total hip arthroplasties. Management of these fractures is often particularly demanding, complex and expensive. In many cases, the surgeon has to solve the simultaneous problems of implant loosening, bone loss and fracture. A thorough understanding of the unique characteristics of the different fracture types, the principles of PFF treatment and a familiarity with the various fixation devices, grafts and prosthetic implants are all of paramount importance. Internal fixation is used either alone or as an adjunct to stem revision. The stability of the original implant and the configuration of the fracture itself are the basic factors that influence the decision-making process. The current study reviews the existing literature on internal fixation of femoral periprosthetic fractures.
Keywords: Periprosthetic fractures; Femur; THR; Biomechanics; Implants; Fixation
摘要：
随着人口分布的变化和开展的全髋关节数量上的增加，股骨假体周围骨折（PFF）也在增加。据报道，在所有全髋关节置换中，其总的发生率在0.1%到6%之间。对于这些骨折的处理往往有着特殊的研究，而且很复杂，费用也高。很多情况下，外科医生必须同时解决植入物松动、骨丢失和骨折等问题。彻底的了解不同骨折类型所特有的特征、PFF的治疗原则，熟悉各种内固定装置、植骨、假体植入等是极为重要的。以往，内固定有单独使用者，也有配合股骨柄翻修而使用者。原始植入物的稳定性和骨折本身的结构是影响治疗决策过程的基本因素。这一研究旨在对现有的有关股骨假体周围骨折内固定方面的文献作一综述。
关键词：假体周围骨折；股骨；THR；生物力学；植入物；固定
7、
股骨假体周围骨折植骨的问题：支撑性、嵌入式或股骨置换（同种异体骨）
Eleftherios Tsiridisa, , , Gavin Spenceb, Zakareya Gamiea, Mohamed A. El Masrya and Peter V. Giannoudisa
aAcademic Department of Trauma & Orthopaedics, School of Medicine, University of Leeds, United Kingdom
bOrthopaedic Research Unit, Department of Surgery, University of Cambridge, United Kingdom
Accepted 28 February 2007. Available online 27 April 2007.
Summary
Peri-prosthetic fractures are technically demanding to treat, as they require the skills of revision arthroplasty as well as those of trauma surgery. [Lindahl H, Malchau H, Herberts P, Garellick G. Periprosthetic femoral fractures classification and demographics of 1049 periprosthetic femoral fractures from the Swedish National Hip Arthroplasty Register. J Arthroplasty 2005;20:857–65.] reporting on 1049 periprosthetic femoral fractures found that the annual incidence varied between 0.045% and 0.13% for all THAs performed in Sweden and that the accumulated incidence for the primary hip arthroplasties was 0.4% while for the revision arthroplasties was 2.1% [Lindahl H, Malchau H, Herberts P, Garellick G. Periprosthetic femoral fractures classification and demographics of 1049 periprosthetic femoral fractures from the Swedish National Hip Arthroplasty Register. J Arthroplasty 2005;20:857–65.]. The elderly population is particularly vulnerable to low energy periprosthetic fractures attributed to osteopenia or osteoporosis leaving limited reconstruction options to the hip revision surgeon. Bone grafting in the form of autograft has well recognized limitations and allograft represents the gold standard of bone augmentation in the majority of the cases. Allograft can be used as morselised in the form of impaction grafting, reconstructing the bone from within out, or in the form of structural allograft. In the latter case, strut onlay plates or whole proximal femoral allografts can be used to augment the deficient bone or to totally replace it respectively. Immune reaction and disease transmission along with delayed revascularization of the cortical allograft can cause failure of the construct in the long term; however, the results to date from their use are promising. We here present an overview of the literature on the use of available bone grafts in the treatment of periprosthetic femoral fractures.
Keywords: Periprosthetic; Femoral; Fractures; Hip revision; Strut grafts; Impaction grafting
摘要
假体周围骨折的处理在技术上有着较高的要求，这不仅需要熟练的关节置换翻修技术，也还需要创伤外科的技术。Lindahl H 等[Lindahl H, Malchau H, Herberts P, Garellick G. Periprosthetic femoral fractures classification and demographics of 1049 periprosthetic femoral fractures from the Swedish National Hip Arthroplasty Register. J Arthroplasty 2005;20:857–65.]报道，他们在1049例股骨假体周围骨折发现，在瑞典进行的所有全髋关节置换中，年发生率（假体周围骨折）在0.045%至0.13%之间，初次全髋关节置换者累计发生率为0.4%，关节置换翻修者则为2.1%[Lindahl H, Malchau H, Herberts P, Garellick G. Periprosthetic femoral fractures classification and demographics of 1049 periprosthetic femoral fractures from the Swedish National Hip Arthroplasty Register. J Arthroplasty 2005;20:857–65.]。由于骨量丢失或骨质疏松，老年患者特别容易导致低能量假体周围骨折，而且由此，髋关节翻修的外科医生进行重建的选择也受到限制。以自体骨移植的方式进行的植骨存在的局限性是被大家公认的，而在大多数病例中同种异体骨被认为是作为骨性植入物的金标准。 同种异体骨可以用微小颗粒进行嵌入式植骨，由内而外地进行骨重建；或者，也可以进行结构性植骨。后一种情况，应用支撑加盖板（异体骨）或整个股骨近端的同种异体骨移植物分别可补充骨缺损或进行完整的置换。从长期来看，免疫反应和疾病的传染伴随着异体皮质骨后期的再血管化，这可能导致这一结构的失败，然而，从人们开始应用至今的结果来看，还是很可观的。我们这里对有效应用骨移植治疗股骨假体周围骨折的文献进行一下综述。
关键词：假体周围；股骨；骨折；髋关节翻修；支撑性植骨；嵌入式植骨
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8、
股骨假体周围骨折挽救性手术和植入物的选择
Alexander Siegmetha, Donald S. Garbuza and Bassam A. Masri , a
aDivision of Lower Limb Reconstrcution and Oncology, University of British Columbia, Vancouver, BC, Canada
Accepted 27 February 2007. Available online 3 May 2007.
Summary
Periprosthetic femoral fractures with severe bone loss are challenging to treat. There are various treatment options, depending on the severity of the bone loss, age and activity of the patient and experience of the surgeon. This review focuses on the treatment of these Vancouver type B3 fractures with long-stem implants, proximal femoral replacements, allograft-prosthesis composites and cortical strut grafting.
Keywords: Salvage; Implant; Periprosthetic femoral fractures
摘要
股骨假体周围骨折伴有严重骨丢失的处理是很有挑战性的。按照骨丢失的严重程度、患者的年龄和活动度以及外科医生的经验不同，存在着多种治疗选择。这一综述主要论述的内容是：应用长柄假体、股骨近端置换、同种异体骨-假体复合物以及皮质骨支撑植骨等方法治疗Vancouver B3型骨折。
关键词：挽救性；植入物；股骨假体周围骨折