Sher Doron, Biant Leela C
Orthosports Clinic and Concord Repatriation General Hospital, Sydney, Australia.
Injury. 2007 Oct;38(10):1209-13. doi: 10.1016/j.injury.2007.04.024. Epub 2007 Sep 18.
Patients presenting with fracture of the femoral neck are usually elderly, and often have extensive co-morbidity. Patients who are considered able to survive an operation under general or regional anaesthesia usually undergo surgical stabilisation of the fracture or hemiarthroplasty of the hip for pain relief, to facilitate mobilisation and minimise the risk of developing the sequelae of bed rest. Patients who are considered too unwell for surgery are often treated non-operatively. These patients have a high morbidity and mortality and present significant nursing difficulties.
We describe a technique for fixation of subcapital fracture of the femoral neck under local anaesthesia direct infiltration only which is suitable for the medically unwell patient who may otherwise be treated non-operatively. A case series of patients on whom it was performed is presented.
None of the patients required a supplementary anaesthetic technique, all survived to discharge from hospital.
We recommend all patients with a subcapital fracture of the femoral neck are offered surgery to optimise their chance of survival and avoid the morbidity associated with bed rest.
股骨颈骨折患者通常为老年人，且常伴有多种并发症。被认为能够在全身麻醉或区域麻醉下耐受手术的患者，通常会接受骨折的手术固定或髋关节半关节置换术，以缓解疼痛、便于活动并降低发生卧床后遗症的风险。被认为身体状况太差无法进行手术的患者，通常采用非手术治疗。这些患者发病率和死亡率高，护理难度大。
我们描述了一种仅通过局部麻醉直接浸润来固定股骨颈头下型骨折的技术，该技术适用于那些否则可能接受非手术治疗的身体状况不佳的患者。本文展示了一组接受该手术的患者病例系列。
所有患者均无需辅助麻醉技术，全部存活至出院。
我们建议为所有股骨颈头下型骨折患者提供手术治疗，以优化其生存机会并避免与卧床相关的发病率。
