髋部转子间骨折治疗的植入物选择：理论依据、证据及建议。
Implant options for the treatment of intertrochanteric fractures of the hip: rationale, evidence, and recommendations.
作者信息
Socci A R, Casemyr N E, Leslie M P, Baumgaertner M R
机构信息
Yale University School of Medicine, Department of Orthopaedics and Rehabilitation, 800 Howard Ave, New Haven, CT 06520, USA.
出版信息
Bone Joint J. 2017 Jan;99-B(1):128-133. doi: 10.1302/0301-620X.99B1.BJJ-2016-0134.R1.
AIMS
The aim of this paper is to review the evidence relating to the anatomy of the proximal femur, the geometry of the fracture and the characteristics of implants and methods of fixation of intertrochanteric fractures of the hip.
MATERIALS AND METHODS
Relevant papers were identified from appropriate clinical databases and a narrative review was undertaken.
RESULTS
Stable, unstable, and subtrochanteric intertrochanteric fractures vary widely in their anatomical and biomechanical characteristics, as do the implants used for their fixation. The optimal choice of implant addresses the stability of the fracture and affects the outcome.
CONCLUSION
The treatment of intertrochanteric fractures of the hip has evolved along with changes in the design of the implants used to fix them, but there remains conflicting evidence to guide the choice of implant. We advocate fixation of 31A1 fractures with a sliding hip screw and all others with an intramedullary device. Cite this article: Bone Joint J 2017;99-B:128-33.
目的
本文旨在综述与股骨近端解剖结构、骨折几何形态、植入物特性以及髋部转子间骨折固定方法相关的证据。
材料与方法
从合适的临床数据库中检索相关论文，并进行叙述性综述。
结果
稳定型、不稳定型及转子下型转子间骨折在解剖学和生物力学特征方面差异很大，用于固定的植入物也是如此。植入物的最佳选择取决于骨折的稳定性，并会影响治疗结果。
结论
髋部转子间骨折的治疗随着用于固定的植入物设计的改变而发展，但在指导植入物选择方面仍存在相互矛盾的证据。我们主张用滑动髋螺钉固定31A1型骨折，用髓内装置固定其他所有类型骨折。引用本文：《骨与关节杂志》2017年；99-B：128 - 33。
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