Periprosthetic femoral fracture treated with shape-memory sawtooth-arm embra cing fixator
- VernacularTitle:形状记忆锯齿臂环抱内固定器治疗股骨假体周围骨折
- Author:
Kerong DAI
;
Yuehua SUN
- Publication Type:Journal Article
- Keywords:
Alloys;
Memory;
Internal fixators;
Arthroplasty,replacement, hip;
Femoral fractures
- From:
Chinese Journal of Orthopaedics
1996;0(09):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To i nv estigate the clinical effect of shape-memory sawtooth-arm em bracing fixator in the management of periprosthetic femoral fracture.Methods Since1994, 21cases of periprosthet-ic femoral fractures had been treated in7hospitals with the shape-memory sawtooth-arm embracing fixator designed and developed b y the Ninth Peoples Hospital,Shanghai Second Medical University(SSMU ).Of the21cases,12were males and9were females,aging from42to83years old. Eighteen of the series ex peri-enced periprosthetic fracture at2weeks to10y ears after joint replacement the fractures were found as oblique,spi ral or comminuted with the fracture lines located between the lesser trochanter and a p oint 5cm distal to the end of prosthetic stem.The other three were revision c ases,in which2cases with osteoporosis had intraoperative spiral fracture and1 case had long segmental osteotomy for removal of the prostheses.One of the 21patients had Z-shaped femoral osteotomy,while the other20cases were clas sified into Jo hannson typeⅠfrac ture in4cases,typeⅡ9cases and typeⅢ7case s.All of them were complete fracture with dis-placement.In practice,the arm s of fixator were expanded firstly by immersing into the ice water to make the tempera ture of the device decrease to4~7℃.After reduction of the fracture ,the body of the fixator was placed on the tensile side of the femur,and th e temperature of the arms was raised with hot saline.With its shape memory ef fect,the sawtooth-arms began to close up and grasped the fracture fragments ti ghtly.Results Surgical process in all of the cases was smoothly done:the frac tures were stable after the fixation,and no ex-ternal fixation was required po stoperatively,except four cases underwent skin traction of the affected lim b for 2weeks.All the patients were able to walk with two crutches at2to4we eks after the operation.The post-operative follow-up lasted from1to7years, and no fracture re-displacement was found.The results of frac-ture healing were good while the functional recovery to the pre-operative level was achieved in the all se ries.Conclusion For periprosthetic femoral fracture,shape memo ry sawtooth-arm embracing fixator is a re liable device being implanted easily and offering stable fixation;it should be the treatment method of the first choice.
