骨科英文书籍精读（275）｜股骨假体周围骨折
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PERIPROSTHETIC FRACTURES
Femoral shaft fractures around a hip implant are uncommon; they may happen during primary hip surgery when reaming or preparing the medullary canal, or when forcing in an over-sized uncemented prosthesis, or during revision surgery while extracting cement or attempting to dislocate the hip if the soft tissue release has been insufficient. Sometimes the fracture occurs much later, and there are usually x-ray signs of osteolysis or implant loosening suggesting a reason for bone weakness.
If the prosthesis is worn or loose, it should be removed and replaced by one with a long stem, thereby treating both problems. If the primary implant is neither loose nor worn it can be left in place and the fracture treated by plate fixation with structural allografts bridging the fracture (Figure 29.28).
---from 《Apley’s System of Orthopaedics and Fractures》
重点词汇整理：
Femoral shaft fractures around a hip implant are uncommon; they may happen during primary hip surgery when reaming or preparing the medullary canal, or when forcing in an over-sized uncemented prosthesis, or during revision surgery while extracting cement or attempting to dislocate the hip if the soft tissue release has been insufficient.
髋关节假体周围股骨干骨折并不常见。可以发生在初次髋关节手术中：当扩髓或准备髓腔或强行使用过大的非骨水泥假体时；或在翻修手术中取出骨水泥或在软组织释放不足的情况下试图脱位髋关节时。
periprosthetic假体周围的
prosthetic /prɑːsˈθetɪk/adj. 假体的；非朊基的
medullary canal骨髓腔
uncemented prosthesis非骨水泥假体
revision surgery翻修手术
extract cement取出骨水泥
dislocate the hip脱位髋关节
osteolysis /,ɔsti'ɔlisis/n. [外科] 骨质溶解
The periprosthetic fracture can be treated by plate fixation with structural allografts bridging the fracture。
（股骨）假体周围骨折可以通过钢板和结构性同种异体骨来桥接固定。
allograft/'æloɡræft/n. [病理] 同种异体移植物（同种异体骨）
百度翻译：
假体周围骨折
髋关节植入物周围的股骨干骨折并不常见；它们可能发生在初次髋关节手术中，当扩孔或准备髓管时，或当强行插入尺寸过大的非骨水泥假体时，或在取出骨水泥或试图脱位髋关节的翻修手术中，如果软组织释放不足。有时骨折发生得很晚，通常有骨溶解或植入物松动的x线征象，提示骨质疏松的原因。
如果假体磨损或松动，应将其取出，换上长柄假体，从而解决这两个问题。如果一期植入物既不松动也不磨损，则可以将其留在原位，并通过结构同种异体骨桥接钢板固定治疗骨折（图29.28）。