亚洲股骨转子间骨折的治疗:我们所知与世界可借鉴之处

Intertrochanteric Femur Fracture Treatment in Asia: What We Know and What the World Can Learn.

作者信息

Chang Shi-Min, Hou Zhi-Yong, Hu Sun-Jun, Du Shou-Chao

机构信息

Department of Orthopedic Surgery, Yangpu Hospital, Tongji University School of Medicine, 450 Tengyue Road, Shanghai 200090, People's Republic of China.

Department of Orthopedic Surgery, Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang 050051, People's Republic of China.

出版信息

Orthop Clin North Am. 2020 Apr;51(2):189-205. doi: 10.1016/j.ocl.2019.11.011. Epub 2020 Jan 30.

Abstract

Hip fractures are of great interest worldwide as the geriatric population continues to increase rapidly. Currently, surgeons prefer to use cephalomedullary nail for internal fixation of pertrochanteric/intertrochanteric fractures. This article summarizes 10 concepts in hip fracture treatment over the past 20 years, including fracture line mapping, proximal lateral wall and anterior cortex, posteromedial lesser trochanter-calcar fragment, anteromedial cortex support reduction, changes of fracture reduction after sliding and secondary stability, nail entry point and wedge-open deformity, tip-apex distance and calcar-referenced tip-apex distance, femoral anterior bowing and nail modification, long nails for wide medullary canal and large posterior coronal fragment, and postoperative stability score.

摘要

随着老年人口的迅速持续增长,髋部骨折在全球范围内备受关注。目前,外科医生更倾向于使用髓内钉对转子周围/转子间骨折进行内固定。本文总结了过去20年中髋部骨折治疗的10个概念,包括骨折线测绘、近端外侧壁和前皮质、后内侧小转子-骨皮质碎片、前内侧皮质支撑复位、滑动后骨折复位变化及二期稳定性、髓内钉进针点与楔形开放畸形、尖顶距及以骨皮质为参照的尖顶距、股骨干前弓与髓内钉改良、用于宽大髓腔及大的后冠状面骨折块的长髓内钉以及术后稳定性评分。

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