Gösling Thomas
Klinik für Unfallchirurgie und Orthopädie, Städtisches Klinikum Braunschweig gGmbH, Holwedestr. 16, 38118, Braunschweig, Deutschland.
Unfallchirurg. 2022 May;125(5):389-403. doi: 10.1007/s00113-022-01175-y. Epub 2022 Apr 8.
Subtrochanteric fractures represent a distinct entity. They are different from proximal femoral fractures as well as femoral shaft fractures. Nowadays, these fractures are mainly found in the geriatric population. Fractures in younger patients are indicative of high-energy trauma. Comorbidities are important in the geriatric population whereas accompanying injuries are most important in younger patients. Early surgical stabilization of subtrochanteric fractures is the treatment of choice, which under certain circumstances should also be carried out within the framework of damage control orthopedics. Long cephalomedullary nails represent the standard procedure. In geriatric patients the primary aim is weight bearing stability. The risk of complications with subtrochanteric fractures in the literature is relatively high. Classical compression plates play a role in the management of complications.
转子下骨折是一种独特的疾病。它们与股骨近端骨折以及股骨干骨折不同。如今,这些骨折主要见于老年人群。年轻患者的骨折提示高能量创伤。合并症在老年人群中很重要,而伴随损伤在年轻患者中最为重要。转子下骨折的早期手术稳定是首选治疗方法,在某些情况下也应在损伤控制骨科的框架内进行。长型髓内钉是标准术式。在老年患者中,主要目标是负重稳定性。文献中转子下骨折的并发症风险相对较高。经典加压钢板在并发症的处理中发挥作用。