Objective To evaluate the clinical results of femoral revision using an uncemented long femoral stems with wire or memory titanium alloy embracing fixator in the treatment of Vancouver type B2 and B3 periprosthetic femoral fractures. Methods We retrospectively reviewed 17 cases of periprosthetic femoral fracture treated with the un-cemented long femoral stem prosthesis. Of these, eight cases were Vancouver type B2 periprosthetic femoral fractures, and nine cases were Vancouver type B3 periprosthetic femoral fractures. The clinical outcomes were assessed with Harris hip score. Radiological evaluations were conducted using Beals and Tower'criteria, and any complication during the fol-low-up period was recorded. Results The average follow-up period was 41.7 months. The average Harris hip score was 68.2 at the final follow-up. All fractures were united. There was femoral stem subsidence less than 10 mm in 4 cases with-out an evidence of loosening both radiologically and clinically. The radiological results using Beals and Towers' criteria were excellent in eight cases, good in five and poor in four. Conclusion An uncemented long femoral stem prosthesis with wire or memory titanium alloy embracing fixator provides a good fracture stability that promotes fracture healing and offers a successful solution for the management of Vancouver type B2 and B3 periprosthetic femoral fractures.%目的 探讨非骨水泥长柄股骨假体治疗人工髋关节置换术后VancouverB型股骨假体周围骨折的临床疗效.方法 回顾性分析宜昌市第一人民医院骨科2008年5月至2014年9月应用非骨水泥长柄股骨假体行股骨侧翻修结合钢丝或记忆合金环抱器固定治疗的Vancouver B2和B3型股骨假体周围骨折患者的临床资料,其中B2型8例,B3型9例.末次随访时采用Harris评分行髋关节功能评估,采用Beals和Tower标准行影像学评估,并记载随访时不良反应.结果 所有患者均获随访,平均随访41.7个月,末次随访时Harris评分平均为68.2分,所有骨折均愈合,4例股骨柄下沉不超过10 mm,无假体松动表现.影像学评估按照Beals和Tower标准,其中优8例,良5例,差4例.结论 加长型非骨水泥型股骨长柄假体加钢丝或环抱器能为骨折愈合提供较好的初始稳定性,有利于骨折愈合,是治疗Vancouver B型股骨假体周围骨折的理想方法.
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