股骨假体周围骨折英文

JI DC, 62yrs, M, 1341747
Dr. F. LIU
UCS Ⅳ.3 B1
(Vancouver type B1)
Dr. F. LIU
LCP with titanium cable system
UCS Ⅳ.3 B2 (Type B2)
59 yrs, M
Dr. F. LIU
UCS Ⅳ.3 B2 (Type B2)
Treatment of Femoral Periprosthetic Fracture
Fan LIU M.D. Ph.D
Prof. Chair Dept. of Orthopedic Surgery Nantong University Hospital
CHINA
Objectives
Goals Epidemiology Risk factors Classification Treatment
UCS Ⅳ.3 B1
( Type B1)
LCP cables biological plate
79 yrs M
Dr. F. LIU
LCP with titanium cable system
Locking-compression plates (LCP) locking-head screw (LHS)
a VA-LCP ( for distal femur) b Angulations of possible screw directions c Design of a VA-LHS screw head
LCP with Locking Attachment Plate
SHI RH, 77yrs, F, 1277045
Around or just distal to stem
Stem region with the stem firmly in place
With loose stem
With bone defect present
Type C
Well below stem
UCS
Unified Classification System
reasonable survivorship of the prosthesis
Femoral Periprostheic Fractures
Epidemiology
incidence
0.56~4.2%
Uncommon but Unique Challenges !
Risk Factors
Old age Female Trauma Index diagnosis Revision Implants Technique Loose implant (aseptic) Rheumatoid Osteopenia Osteolysis
a LCP DF ( for distal femur) b LCP PT ( for proximal tibia) c LHS ( monocortical short ) for placement in the
vicinity of a prosthetic stem
Variable-angle locking compression plate (VA-LCP) and locking head screw (LHS)
B1 Good bone no implant loosening
B2 Good bone with implant loosening
B3 Poor bone or bone defect, implant loosening
Unified Classification System
Treatment
get help
Surgical solutions
Internal fixation
plating nailing
Revision of prosthetic components
UCS Ⅳ.3 A
( Type A)
Stable
conservation trochanter plate cerclage wires
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Pre-op Planning
rule out infection • ESR
• CRP
implant fixation
• revision • tumor prosthesis
• IM nail • LCP • Cable • Biological plate • Other
escape plan
Goals of Treatment
fracture union anatomic alignment
stable prosthesis at the end of fracture healing
early mobilization
return to functional status
Classification ?
Dr. F. LIU
UCS Ⅳ.3 B1 (Vancouver type B1)
Surgical solution
LCP with Locking Attachment Plate
Dr. F. LIU
Dr. F. LIU
Dr. F. LIU
Dr. F. LIU
Classification
Vancouver
Type A
Fractures in the trochanteric region
AG: fractures of the greater trochanter AL: fractures of the lesser trochanter
Type B
Dr. F. LIU
UCS Ⅳ.3 C
( Type C)
Surgical solution
LISS
LCP ± Cables
Dr. F. LIU
Dr. F. LIU
Surgical solution
LCP
with titanium cables system
revision • long stem with cable system • tumor prosthetic
JI MF, 62yrs, F, 1277986
Dr. F. LIU
Dr. F. LIU