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减少股骨转子下骨折:技巧与窍门、注意事项

Reducing subtrochanteric femur fractures: tips and tricks, do's and don'ts.

作者信息

Yoon Richard S, Donegan Derek J, Liporace Frank A

机构信息

*Division of Orthopaedic Trauma, Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY; and †Division of Orthopaedic Trauma, Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA.

出版信息

J Orthop Trauma. 2015 Apr;29 Suppl 4:S28-33. doi: 10.1097/BOT.0000000000000287.

Abstract

Treatment of subtrochanteric fracture remains a challenge, but evolution of strategy has allowed for reliable results with low complications. Although several fixation options exist, reamed, antegrade intramedullary nailing (IMN) has evolved as the standard of care. Cognizant effort to achieve anatomic reduction before IMN passage allows for desired outcomes. Several reduction techniques can be used to overcome the deforming forces present in the proximal femur to allow for proper IMN placement. The purpose of this article is to review the tips, tricks, and pitfalls to avoid in the treatment of subtrochanteric femur fractures with IMN.

摘要

股骨转子下骨折的治疗仍然是一项挑战,但治疗策略的发展已能带来可靠的结果且并发症发生率低。尽管存在多种固定选择,但扩髓顺行髓内钉固定术(IMN)已成为标准治疗方法。在插入髓内钉之前有意识地努力实现解剖复位可带来理想的治疗效果。可采用多种复位技术来克服股骨近端存在的变形力,以确保髓内钉的正确置入。本文旨在回顾使用髓内钉治疗股骨转子下骨折时应掌握的技巧、窍门以及需避免的失误。

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