Objective To analyze the incidence management and outcomes of intraoperative periprosthetic fractures associated with the insertion of uncemented stems around primary total hip arthroplasty( THA) . Methods 623 stem-med implants in 559 cases of THA were analyzed retrospectively. Results 43 patients of 559 cases who sustained in-traoperative periprosthetic fractures were classified according to the Vancouver system:5 cases type A1 fractures, 3 type B1, 13 type B2, 6 type A2L, 6 type A2G, 8 type A3L, 2 type A3G were recognized in the study. All the patients were used cerclage wiring or conservative treatment and healed uneventfully. 43 patients were completed review with 12~37 months and none of them were found implant migration loosening until the end of the review. The Harris score ranged from 77~91 points. Conclusions Most of the intraoperative periprosthetic fracture are non- or minimally displaced. Female gender is absolutely associated ( P =0. 002 ) and diameter of implant is significantly associated with intraoperative periprosthetic fractures ( P=0. 031 ) , cerclage wiring can be used to treated type A3 L and A3 G fractures in the operation and bear weight postponed for 2~3 months until fracture healing and obtain a favorable cur-ative effect.%目的 分析初次全髋关节置换术( THA)术中与植入生物柄相关的假体周围骨折的因素及处理方法.方法 对559例THA术中使用的623个植入假体进行回顾性研究. 结果 559例中43例发生术中假体周围股骨骨折,按Vancouver型标准进行分类:A1型5例,B1型3例,B2型13例,A2L 型6例,A2G型6例,A3L 型8例,A3 G 型2例. 分别用钢丝环扎固定、术后卧床等治疗,均愈合良好. 43 例均获得随访,时间12 ~37 个月. 均未见假体松动,Harris评分为77~91分. 结论 THA术中与生物柄相关的假体周围骨折多为轻微骨折. 假体周围骨折与性别为女性存在绝对相关( P=0. 002 ) ,与假体直径的相关性较明显( P=0. 031 ). Van-couver A3 L、A3 G 型的假体周围骨折术中采用钢丝环扎固定并延长术后卧床时间,可促进骨折愈合,不影响术后功能.
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