Lirtsman V M, Mikhaĭlenko V V, Lukin V P
Ortop Travmatol Protez. 1990 Feb(2):42-6.
The methods of treatment of trochanteric fractures of the femur depend on both on the peculiarities of the fracture of this part of the bone and on the general state of elderly and old people aggravated with accompanying diseases of the inner organs. The immobilization-free method was used in extremely severe cases. The mortality rate in the patients of this group was the highest. Skeletal traction still remains the main method of treating trochanteric fractures. However, this method is connected with a long period of bed rest, a danger of the development of hypostatic complications, and requires a long rehabilitation period. Surgical treatment with immersion osteosunthesis using a two or three flange nail with diaphyseal application is rather traumatic and does not allow the patients to move with a full load on the extremity at early terms, although it permits to mobilize them at earlier terms. The mortality rate is almost the same as in the treatment with skeletal traction. External perosseous osteosynthesis is low traumatic and allows to walk with a full load on the extremity at early terms, yet it requires regular observation and dressings, which prolongs the in-patient treatment period. The most prospective method of treatment of trochanteric fractures in elderly and old people is intramedullary osteosynthesis after Ender or Lezius.
股骨转子间骨折的治疗方法既取决于该部位骨折的特点，也取决于伴有内脏疾病的老年人和高龄老人的一般状况。在极其严重的病例中采用无固定方法。该组患者的死亡率最高。骨骼牵引仍然是治疗转子间骨折的主要方法。然而，这种方法与长期卧床休息有关，有发生坠积性并发症的风险，并且需要较长的康复期。使用双或三翼钉进行骨干应用的髓内固定手术创伤较大，并且在早期不允许患者在肢体完全负重的情况下活动，尽管它能使患者更早活动。其死亡率与骨骼牵引治疗的死亡率几乎相同。骨外固定创伤小，允许患者在早期肢体完全负重的情况下行走，但需要定期观察和换药，这延长了住院治疗时间。治疗老年人和高龄老人转子间骨折最有前景的方法是采用恩德尔（Ender）或莱齐乌斯（Lezius）方法后的髓内固定。
