Lucke M, Stöckle U, Lucke C
Abteilung Unfallchirurgie, Klinikum rechts der Isar der Technischen Universität München, München, Germany.
Z Gerontol Geriatr. 2009 Aug;42(4):311-6. doi: 10.1007/s00391-008-0016-2. Epub 2009 Jun 26.
Operative stabilisation of femural neck fractures is a routine procedure nowadays and is usually performed without delay. Treatment by osteosynthesis or endoprosthesis allows immediate mobilisation with at least partial weight bearing.Immobilisation for months, associated with high mortality as practiced in former times, is nearly forgotten. We present a review on 430 years of diagnosis and treatment of these fractures since the first description by Ambroise Paré. In fact, it took 150 years to recognise the different locations of various hip fractures; at the time, fractures close to the caput were felt to have no chance of healing. Impacted fractures of the femural neck were first described 250 years after the first publication by A. Paré.This article also presents an overview on the development of various treatments to stabilise hip fractures: closed reduction and repositioning by internal rotation of the external rotated leg, positioning of the leg on the double inclined splint, different types of extension treatment and finally early operative procedures, when asepsis was established and fractures could be imaged by x-rays.
如今，股骨颈骨折的手术稳定是一种常规手术，通常会立即进行。通过骨合成或假体进行治疗可实现早期活动，并至少部分负重。过去那种需要数月固定且死亡率高的做法几乎已被遗忘。自安布鲁瓦兹·帕雷首次描述以来，我们对这些骨折430年的诊断和治疗进行了综述。实际上，认识到各种髋部骨折的不同位置花了150年时间；当时，靠近股骨头的骨折被认为没有愈合的机会。股骨颈嵌插骨折在A. 帕雷首次发表250年后才被首次描述。本文还概述了稳定髋部骨折的各种治疗方法的发展：通过外旋腿内旋进行闭合复位和重新定位、将腿置于双斜面夹板上、不同类型的牵引治疗，以及最后在建立了无菌技术且骨折可用X射线成像时的早期手术方法。
