Hansjoerg Wyss Hip and Pelvis Center at Swedish Hospital Seattle, WA.
Department of Orthopaedic Surgery, Saint Louis University School of Medicine, St. Louis, MO.
J Orthop Trauma. 2018 Feb;32 Suppl 1:S46-S54. doi: 10.1097/BOT.0000000000001087.
Despite improvements in surgical technique and overall patient care, failed treatment of fractures of the femoral neck persists. For the physiologically young patient, joint preservation is the preferred method of treatment. Unfortunately, the best treatment option, proximal femoral osteotomy, is fast becoming a lost art. Preoperative planning is critical in this regard. The described preoperative planning work flow is a reliable method for obtaining the desired deformity correction for a variety of proximal femoral malunions and nonunion. Revisiting the classic Pauwels osteotomy for femoral neck nonunion is an appropriate vehicle to supply the first link in resurrecting this treatment modality by providing a standardized preoperative planning protocol.
尽管手术技术和整体患者护理有所改善,但股骨颈骨折的治疗失败仍然存在。对于生理上年轻的患者,关节保留是首选的治疗方法。不幸的是,最好的治疗选择,即股骨近端截骨术,正迅速成为一种失传的艺术。术前规划在这方面至关重要。所描述的术前规划工作流程是一种可靠的方法,可用于获得各种股骨畸形愈合和不愈合的所需畸形矫正。重新审视经典的 Pauwels 截骨术治疗股骨颈不愈合是提供这种治疗方式的第一个环节的合适手段,通过提供标准化的术前规划方案。