From the Department of Orthopaedic Surgery, University of California Los Angeles, Los Angeles, CA.
J Am Acad Orthop Surg. 2022 Sep 15;30(18):867-878. doi: 10.5435/JAAOS-D-21-01007. Epub 2022 May 25.
The incidence of pertrochanteric hip fractures continues to rise as the aging population expands. Despite advancements in techniques and implants, failure rates remain up to 16% in the literature. The recognition of challenging fracture patterns and the use of meticulous preoperative planning can help to avoid common pitfalls. Understanding fluoroscopic views for reduction assessment and implant placement is instrumental in preventing fixation failure. In addition, adjunctive techniques including the use of a bone hook, cerclage wire, and colinear clamps can facilitate reduction efforts. It is imperative for the surgeon to recognize common pitfalls and to consider a wide array of techniques to manage these challenging and common fractures.
随着人口老龄化的加剧,股骨转子间骨折的发病率持续上升。尽管技术和植入物不断进步,但文献报道的失败率仍高达 16%。认识到具有挑战性的骨折模式,并进行细致的术前规划,可以帮助避免常见的陷阱。了解透视下复位评估和植入物放置的影像学视图对于防止固定失败至关重要。此外,辅助技术,如使用骨钩、环扎线和同轴夹,也可以辅助复位。对于外科医生来说,认识到常见的陷阱,并考虑广泛的技术来处理这些具有挑战性和常见的骨折是至关重要的。