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股骨近端移位囊内骨折的复位与固定

Reduction and fixation of displaced intracapsular fractures of the proximal femur.

作者信息

Bosch Ulrich, Schreiber Thomas, Krettek Christian

机构信息

Department of Trauma Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, D-30625 Hannover, Germany.

出版信息

Clin Orthop Relat Res. 2002 Jun(399):59-71. doi: 10.1097/00003086-200206000-00009.

Abstract

Intracapsular fractures of the femoral neck are one of the most common fractures in the elderly. The incidence of these fractures will increase significantly in the next decades as a result of increasing life expectancy. Although treatment of these fractures by closed or open reduction and internal fixation is standard in young patients, arthroplasty is the standard treatment in geriatric patients in most countries. Comorbidities of the patients and current socioeconomic changes in healthcare led to reconsideration of closed reduction and internal fixation of femoral neck fractures as an alternative treatment modality. With correct decision-making, proper reduction, and proper consideration of the biomechanical principle of three-point fixation, minimally invasive screw fixation of femoral neck fractures is a safe and inexpensive procedure even in elderly patients. The purpose of the current review was to give an overview of the history, current techniques and developments, results, limitations, and complications of closed reduction and internal fixation of intracapsular femoral neck fractures.

摘要

股骨颈囊内骨折是老年人最常见的骨折之一。由于预期寿命的增加,在未来几十年中,这些骨折的发生率将显著上升。尽管对于年轻患者,通过闭合或切开复位内固定治疗这些骨折是标准方法,但在大多数国家,关节置换术是老年患者的标准治疗方法。患者的合并症以及当前医疗保健领域的社会经济变化,促使人们重新考虑将股骨颈骨折的闭合复位内固定作为一种替代治疗方式。通过正确的决策、恰当的复位以及对三点固定生物力学原理的合理考量,即使对于老年患者,股骨颈骨折的微创螺钉固定也是一种安全且经济的手术。本综述的目的是概述股骨颈囊内骨折闭合复位内固定的历史、当前技术与进展、结果、局限性及并发症。

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