Davidovitch Roy I, Jordan Charles J, Egol Kenneth A, Vrahas Mark S
Department of Orthopaedic Surgery, Orthopaedic Trauma Service, NYU Hospital for Joint Diseases, 301 East 17th Street, Suite 1402, New York, NY 10003, USA.
J Trauma. 2010 Jan;68(1):236-42. doi: 10.1097/TA.0b013e3181c428ce.
Femoral neck fractures in young patients are a relatively rare event and are often the consequence of a high-energy injury. Concomitant injuries are present more than 50% of the time. Previous reports have found the rate of nonunion and avascular necrosis in this population to be as high as 35% and 45%, respectively. The salvage options, which tend to yield more acceptable results in elderly patients with femoral neck fractures, yield disproportionately poor results in young, active patients who are often productive members of the labor force. Many reports exist in the literature evaluating the various treatment options of these injuries. This review will address the epidemiology and diagnosis of the injury. In addition, the various treatment options in the acute presentation, as well as options available for treating the sequelae of femoral neck fractures in the young, will be discussed. Although longer life expectancy and the sustained activity level of many people previously considered elderly has blurred the definition of "young," this review will use the available literature dealing with skeletally mature patients up to the age of 60 years.
年轻患者的股骨颈骨折相对少见，通常是高能损伤的结果。超过50%的情况下存在合并伤。既往报告发现，该人群的骨不连和股骨头缺血性坏死发生率分别高达35%和45%。对于老年股骨颈骨折患者往往能产生更可接受结果的挽救治疗方案，在年轻、活跃且通常是劳动力中有生产力成员的患者中却产生了不成比例的不良结果。文献中有许多报告评估了这些损伤的各种治疗选择。本综述将探讨该损伤的流行病学和诊断。此外，还将讨论急性表现时的各种治疗选择，以及年轻患者股骨颈骨折后遗症的可用治疗方案。尽管预期寿命延长以及许多以前被认为是老年人的人的持续活动水平模糊了“年轻”的定义，但本综述将采用现有文献中针对骨骼成熟且年龄在60岁以下患者的研究。
