Vancouver B2 型股骨假体周围骨折锁定板或皮质骨板不同内固定方式的 生物力学分析.

BACKGROUND: Periprosthetic fractures are severe complications after hip arthroplasty. The treatments could be varied. However, there is still a lack of validated comparison of these treatments. OBJECTIVE: To compare different treatments of Vancouver type B2 fracture based on finite element analysis. METHODS: The data of femurs of 30 healthy volunteers, primary and revision prosthesis and locking compress plate were collected. The data were input into finite element analysis software. Different surgeries for Vancouver type B2 fracture and different types of loads were simulated. The fracture end offset of the cortical bone plate group, locking plate group, cortical bone plate + cortical bone plate group, and cortical bone plate + locking plate group under different loads were recorded, and statistical analysis was performed. RESULTS AND CONCLUSION: (1) Under 2 300 N force load, the offset of cortical bone plate group was significantly greater than that of the other three groups (P < 0.05). The offset of locking plate group was significantly greater than that of cortical bone plate + cortical bone plate group and cortical bone plate + locking plate group (P < 0.05). However, the offset of cortical bone plate + cortical bone plate group was not significantly different from that of cortical bone plate + locking plate group (P > 0.05). (2) Under 40 N•m torque load, there was no significant difference in offset between cortical bone plate group and cortical bone plate + cortical bone plate group (P > 0.05). There was no significant difference in the offset between the locking plate group and the cortical bone plate + locking plate group (P > 0.05). The offset of cortical bone plate group and cortical bone plate + cortical bone plate group was significantly greater than that of locking plate group and cortical bone plate + locking plate group (P < 0.05). (3) For Vancouver type B2 fracture, after stem revision, if it is not stable enough, locking plate should be used as first choice, and adding a allograft strut could be sensible if necessary. [ABSTRACT FROM AUTHOR]