Saxer F, Studer P, Jakob M
Klinik für Traumatologie, Universitätsspital Basel, Spitalstraße 21, CH-4031, Basel, Schweiz.
Unfallchirurg. 2011 Dec;114(12):1122-7. doi: 10.1007/s00113-011-2064-0.
Fractures of the acetabulum after low-energy trauma in geriatric patients suffering from osteoporosis are increasing in number and significance due to demographic changes. The results of current therapeutic principles though tend to be poor in this population, while risk and treatment-related morbidity of surgical or conservative approaches are substantial.The treatment of geriatric patients can be challenging, not only because of their often complex medical history. They essentially need rapid functional restoration and return to their familiar environment to avoid general decline unlike younger patients for whom rather the long-term perspective is crucial. This article critically discusses the current literature and reports on first experiences with a new surgical concept in six geriatric patients aged 82-91 years: the combination of an anterior minimally invasive approach for open reduction and internal fixation of the acetabulum combined with an anterior minimally invasive (AMIS®) approach to the hip for total hip arthroplasty with promising short-term results.
由于人口结构变化,老年骨质疏松患者因低能量创伤导致的髋臼骨折数量不断增加,其重要性也日益凸显。然而,目前的治疗原则在这一人群中的效果往往较差,而手术或保守治疗方法的风险及与治疗相关的发病率却很高。老年患者的治疗颇具挑战性,不仅因为他们往往有着复杂的病史。与年轻患者不同,年轻患者更注重长期预后,而老年患者本质上需要快速恢复功能并回到熟悉的环境中,以避免身体机能全面衰退。本文批判性地讨论了当前的文献,并报告了对6名年龄在82 - 91岁的老年患者采用一种新手术概念的首次经验:采用前路微创入路进行髋臼切开复位内固定,同时结合前路微创(AMIS®)入路进行全髋关节置换术,短期效果良好。