【专题文献】之人工髋关节置换——下肢假体周(3)

【专题文献】之人工髋关节置换——下肢假体周围骨折的处理

表

1

Coventry classification (Modified from Ninan et al.13)

Ninan et al. produced the Coventry classification for PPF.13 We find this is comprehensive, easy to apply and also helpful in decision making for what is difficult and challenging problem. They divided periprosthetic fractures into two types; Type 1 hips include the happy hips , did not have problems pre-injury, and whose X-Ray shows that the stem is generally well-fixed with no evidence of loosening, or bone loss. In these cases treatment should focus on treating the fracture without interfering with the prosthesis.

In Type 2, or unhappy hips the fixation is compromised and the implant has to be revised as part of the treatment of the fracture.

Vancouver classification

The Vancouver Classification can be used similarly, but is far more complex. Types A, B1 and C can be managed in the same way as the type 1(happy hips), whereas types B2 and B3 can be thought of as type 2 (unhappy) hips, which require revision (Table 2).

考文垂分类（Ninan等改进）

Ninan等发明了用于PPF的考文垂分类，我们发现该分类很广泛，容易应用，也对那些困难和有挑战性问题的治疗选择有帮助。他们将假体周围骨折分为两类，1型的髋包括：“幸福的髋”，伤前没有问题，和那些X线片显示假体干总体固定良好没有松动的表现，或骨丢失。在这些案例的治疗中，应该集中于治疗骨折，不干扰假体。

在2型，或称之不“令人烦恼的髋”，假体固定受到危害，作为治疗骨折的一部分，假体必须进行翻修。

温哥华分类

温哥华分类使用简单，但是远为复杂。A型，B1和C型能使用相同的路径治疗，如同考文垂分类1型，而B2型和B3型能看成为考文垂分类2型，需要进行翻修。（表2）

表2

Vancouver classification