小心你的别针！机器人辅助膝关节置换术后早期股骨假体周围骨折伴双钢板固定

Q4 Medicine

Trauma Case Reports Pub Date : 2025-04-15 DOI:10.1016/j.tcr.2025.101182

Jaime Sánchez del Saz , Jaime Coderch Carretero , Javier García Coiradas , Rodrigo García Crespo

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引用次数: 0

摘要

机器人辅助骨科手术越来越受欢迎，因为它有几个因素，如在假体植入中提高精度和对齐的潜力，以及它更好的疼痛控制和减少住院时间。然而，钉相关的假体周围骨折等并发症虽然罕见，但强调了钉置入技术精度和充分的术后监测的重要性。我们报告一位76岁的肥胖女性患者，在机器人辅助全膝关节置换术两个月后，因站立高度跌倒而出现严重疼痛和膝关节周围畸形。x线片显示股骨假体周围移位骨折在跟踪针位置没有相关的假体不稳定。手术治疗包括联合钢板钉固定，促进了早期负重和功能恢复。术后1年，患者骨折愈合和功能良好，膝关节社会评分为92，EuroQol-5D指数为0.78。虽然与其他固定方法相比，钉板联合固定更具侵入性，但由于其生物力学优势，支持早期活动和负重，可靠的骨折愈合，因此可能是治疗机器人辅助关节置换术后股骨远端骨折的有效策略，特别是对于肥胖和老年患者。

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Watch out your pins! Periprosthetic femoral fracture at tracking pin site early after robotic-assisted knee arthroplasty treated with dual nail-plate fixation

Robotic-assisted orthopedic surgeries are gaining popularity due to several factors such as its potential for enhanced precision and alignment in prosthetic implant placement, as well as its better pain control and reduction in hospital stay time. However, complications such as pin-related periprosthetic fractures, though rare, highlight the importance of technical precision during pin placement and adequate postoperative monitoring.

We present the case of a 76-year-old obese female patient who presented to the Emergency Department with severe pain and deformity around the knee two months after robotic-assisted total knee arthroplasty following a fall from standing height. Radiographs revealed a displaced femoral periprosthetic fracture at tracking pin sites without associated implant instability. Surgical management involved combined nail-plate fixation, which promoted both early weight-bearing and functional recovery. At one year postoperatively, the patient achieved satisfactory fracture healing and functional outcomes, with a Knee Society Score of 92 and an EuroQol-5D index value of 0.78.

Combined nail-plate osteosynthesis, though more invasive compared to other fixation methods, could be an effective strategy for managing distal femoral fractures following robotic-assisted arthroplasty, especially in obese and elderly patients, due to its biomechanical advantages, supporting early mobilization and weight-bearing with reliable fracture healing.

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来源期刊

Trauma Case Reports Medicine-Emergency Medicine

CiteScore

0.60

自引率

0.00%

发文量

131

审稿时长

26 weeks

期刊介绍： Trauma Case Reports is the only open access, online journal dedicated to the publication of case reports in all aspects of trauma care and accident surgery. Case reports on all aspects of trauma management, surgical procedures for all tissues, resuscitation, anaesthesia and trauma and tissue healing will be considered for publication by the international editorial team and will be subject to peer review. Bringing together these cases from an international authorship will shed light on surgical problems and help in their effective resolution.