Sekeitto Allan Roy, Sikhauli Nkhodiseni, van der Jagt Dick Ronald, Mokete Lipalo, Pietrzak Jurek R T
Arthroplasty Unit, Division of Orthopaedic Surgery, Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand, Johannesburg, South Africa.
EFORT Open Rev. 2021 Feb 1;6(2):139-144. doi: 10.1302/2058-5241.6.200036. eCollection 2021 Feb.
This article serves to review the existing clinical guidelines, and highlight the most recent medical and surgical recommendations, for the management of displaced femoral neck fractures (FNFs). It stresses the need for multi-disciplinary intervention to potentially improve mortality rates, limit adverse events and prevent further economic liability.Globally, the incidence of FNFs continues to rise as the general population ages and becomes more active. The annual number of FNFs is expected to exceed six million by 2050. The increased burden of FNFs exacerbates the demand on all services associated with treating these injuries.The management of FNFs may serve as an indicator of the quality of care of the geriatric population. However, despite escalating health costs, a significant 30-day and one-year mortality rate, increased rate of peri-operative adverse events and sub-optimal functional clinical outcomes, continued controversy exists over optimal patient care.Much debate exists over the type of surgery, implant selection and peri-operative clinical care and rehabilitation. FNF care models, systematized clinical pathways, formal geriatrics consultation and specialized wards within an established interdisciplinary care framework may improve outcomes, mitigate adverse events and limit unnecessary costs. Cite this article: 2021;6:139-144. DOI: 10.1302/2058-5241.6.200036.
本文旨在回顾现有的临床指南，并着重介绍针对移位型股骨颈骨折（FNFs）治疗的最新医学和外科建议。文中强调了多学科干预的必要性，以潜在地提高死亡率、限制不良事件并防止进一步的经济负担。在全球范围内，随着总人口老龄化以及活动量增加，股骨颈骨折的发病率持续上升。预计到2050年，股骨颈骨折的年发病数量将超过600万。股骨颈骨折负担的增加加剧了对所有与治疗这些损伤相关服务的需求。股骨颈骨折的治疗可作为老年人群护理质量的一个指标。然而，尽管医疗成本不断攀升，30天和一年的死亡率仍居高不下，围手术期不良事件发生率增加，功能临床结局欠佳，但对于最佳患者护理仍存在持续的争议。关于手术类型、植入物选择以及围手术期临床护理和康复存在诸多争论。在既定的跨学科护理框架内，股骨颈骨折护理模式、系统化临床路径、正式的老年病咨询以及专科病房可能会改善治疗效果、减轻不良事件并限制不必要的费用。引用本文：2021;6:139 - 144。DOI: 10.1302/2058 - 5241.6.200036。
