Hayashi Yasufumi
Tokyo Metropolitan Rehabilitation Hospital, Department of Orthopaedics.
Clin Calcium. 2007 Jun;17(6):964-71.
Although it is obvious that femoral neck fracture shows the worst prognosis of the physical function among variously osteoporotic symptoms, it is true that the fracture is the most painful disease. The fracture is treated to recover the physical function, instead of relieving the pain. Femoral neck fracture is classified into medial fracture broken at the inside of the capsule of hip joint and lateral fracture broken at the outside. A foreign paper emphasized the efficacy of early surgical treatment to relieve the pain, but in late day, correct surgery under the control of complications is revealed to introduce a good physical function and low mortality in Japan, as almost all the patients with femoral neck fracture is 80 years old or over, and have variously severe complications. Even in the delayed operation, early intervention of rehabilitation leads lower mortality and better prognosis of physical function. Femoral neck fracture is recently treated by those advanced surgery and rehabilitation, but number of independent patient reduced by two third and one of bed-ridden patient increased by 2.5 times one year after the fracture. So it would be important that the occurrence of femoral neck fracture reduced by increase of bone strength, prevention of falls, and adaptation of hip protector.
尽管很明显，在各种骨质疏松症状中，股骨颈骨折的身体功能预后最差，但该骨折确实是最疼痛的疾病。治疗该骨折是为了恢复身体功能，而非缓解疼痛。股骨颈骨折分为在髋关节囊内部断裂的内侧骨折和在外部断裂的外侧骨折。一篇外国论文强调了早期手术治疗缓解疼痛的疗效，但后来发现，在日本，在控制并发症的情况下进行正确手术可带来良好的身体功能和低死亡率，因为几乎所有股骨颈骨折患者都在80岁及以上，且有各种严重并发症。即使是延迟手术，早期康复干预也会降低死亡率并改善身体功能预后。最近，股骨颈骨折通过先进的手术和康复进行治疗，但骨折一年后，独立患者数量减少了三分之二，卧床患者数量增加了2.5倍。因此，通过增强骨强度、预防跌倒和使用髋部保护器来减少股骨颈骨折的发生非常重要。
