コーン型セメントレスステム（LIMA Modulus®）の使用経験

Experience of Using Cementress Cone Type Stem (LIMA Modulus®)

　背景：大腿骨頚部骨折後の偽関節や大腿骨転子部骨折後の陳旧例といったサルベージ症例に対し，コーン型セメントレスステム(LIMA Modulus^®)を使用した．

　対象と方法：全4例stovepipe型で，JOAスコア，術前・術後のX線的評価を行った．

　結果：Spot weldsはzone 2，3，5，6で認め，全例でステムの沈下は認めていないが，stress shieldingは認めた．

　まとめ：このステムは菲薄化した骨質に対しても良好な固定性を獲得でき，脆弱な骨質に対しても有効な機種の1つで，大腿骨近位部骨折後のサルベージ症例にも有効と考える．

　Background：We used a cone-type cementless stem (LIMA Modulus^®) to treat fracture nonunion, including postoperative femoral neck nonunion and old trochanteric fracture cases.

　Method：In all of the cases, the canal of the proximal femur has a stove-pipe shape (wide canal and poor cortical bone).　We evaluated the Japanese Orthopaedics Association (JOA) Hip score and pre- and post-operative radiographs.

　Outcome：Stability of the cone-type cementless stem was acquired from the mid-femur to the distal femur.　No subsidence of the stems has been observed.　The stems are also highly stable in relation to poor quality bone in the femur, as in femurs that have a stove-pipe canal.

　Conclusion：We concluded that the cone-type cementless stem is a valid implant for the treatment of nonunion of femoral fractures in femurs that have a stove-pipe canal.