Zhou Yangyang, Ni Yingjie, Li Xingjuan, Chen Hui, Rui Yunfeng
Department of Traumatic Orthopaedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing Jiangsu, 210009, P.R.China;Institute of Traumatic Orthopaedics, School of Medicine, Southeast University, Nanjing Jiangsu, 210009, P.R.China;Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing Jiangsu, 210009, P.R.China;Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing Jiangsu, 210009, P.R.China.
Department of Orthopaedics, Xishan People's Hospital of Wuxi, Wuxi Jiangsu, 214105, P.R.China;Department of Orthopaedics, Wuxi Branch of Zhongda Hospital, School of Medicine, Southeast University, Nanjing Jiangsu, 214105, P.R.China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2019 Aug 15;33(8):1033-1040. doi: 10.7507/1002-1892.201901118.
To introduce the research progress of conservative treatment, internal fixation, hip arthroplasty, and multidisciplinary team (MDT) modes in the treatment of femoral neck fracture in the elderly.
By consulting domestic and foreign literature in recent years, the characteristics and application of various treatment methods and new treatment modes for femoral neck fracture in the elderly were summarized and analyzed.
The elderly non-displaced femoral neck fracture should be treated surgically, and conservative treatment has a high risk of secondary displacement. The displaced fracture should be operated as soon as possible. There is no difference in long-term functional outcome between hemiarthroplasty and total hip arthroplasty. Hemiarthroplasty has less intraoperative blood loss, shorter operation time, and is suitable for the elderly patients with poor basic condition. Total hip arthroplasty is suitable for the elderly patients with better basic condition and higher demand of life quality. MDT can effectively reduce preoperative waiting time and length of stay, reduce the incidence of medical complications, improve the nutritional status of patients, and reduce the mortality of patients.
Significant results have been achieved in the treatment of femoral neck fractures in the elderly by methods such as internal fixation, hip arthroplasty, and MDT.
介绍保守治疗、内固定、髋关节置换术以及多学科团队（MDT）模式在老年股骨颈骨折治疗中的研究进展。
通过查阅近年来国内外文献，总结并分析老年股骨颈骨折各种治疗方法及新治疗模式的特点与应用。
老年无移位股骨颈骨折应采取手术治疗，保守治疗继发移位风险高。移位骨折应尽早手术。半髋关节置换术与全髋关节置换术的长期功能结局无差异。半髋关节置换术术中失血少、手术时间短，适用于基础状况差的老年患者。全髋关节置换术适用于基础状况较好、对生活质量要求较高的老年患者。MDT可有效缩短术前等待时间和住院时间，降低医疗并发症发生率，改善患者营养状况，降低患者死亡率。
内固定、髋关节置换术及MDT等方法在老年股骨颈骨折治疗中取得了显著成效。
