Koval KJ, Zuckerman JD
Department of Orthopaedic Surgery, Hospital for Joint Diseases, New York.
J Am Acad Orthop Surg. 1994 May;2(3):150-156. doi: 10.5435/00124635-199405000-00003.
Surgical stabilization followed by early mobilization is the treatment of choice for both nondisplaced and displaced intertrochanteric fractures. Fracture stability is dependent on the status of the posteromedial cortex. The sliding hip screw is the device mostly commonly used for fracture stabilization. The most important aspect of its insertion is secure placement within the femoral head. Although the sliding hip screw allows postoperative fracture impaction, it is essential to obtain an impacted reduction at the time of surgery. If there is a large posteromedial fragment, an attempt should be made to internally fix the fragment with a lag screw or cerclage wire. Although intramedullary hip screws have not been shown to be superior to the sliding hip screw, they may have selected indications.
手术稳定固定并早期活动是治疗无移位和移位型粗隆间骨折的首选方法。骨折稳定性取决于后内侧皮质的状况。滑动髋螺钉是最常用于骨折固定的器械。其置入的最重要方面是在股骨头内安全放置。尽管滑动髋螺钉允许术后骨折嵌插，但在手术时获得嵌插复位至关重要。如果存在大的后内侧骨折块，应尝试用拉力螺钉或环扎钢丝对骨折块进行内固定。尽管髓内髋螺钉尚未显示出优于滑动髋螺钉，但它们可能有特定的适应证。
