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一篇《骨与关节外科杂志》教育文章：成人股骨颈骨折，重点是手术治疗。

An Acta Orthopaedica educational article: Femoral neck fractures in adults with emphasis on surgical treatment.

作者信息

Rogmark Cecilia, Viberg Bjarke, Wolf Olof, Mukka Sebastian, Costa Matthew L, Gjertsen Jan-Erik

机构信息

Department of Orthopaedics, Lund University, Skåne University Hospital, Malmö, Sweden.

Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark.

出版信息

Acta Orthop. 2025 Aug 18;96:632-639. doi: 10.2340/17453674.2025.44354.

DOI:10.2340/17453674.2025.44354
PMID:40823707
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12359207/
Abstract

Femoral neck fractures (FNFs) are associated with loss of function in all ages and excess mortality. The societal costs are high. Treatment needs to be tailored based on fracture type, functional demand, and physiological age of the patient. Internal fixation is often preferred for undisplaced FNFs and for displaced FNFs in young patients. Anatomical reduction is essential, but slight valgus is accepted. For a majority of those with displaced FNFs, a cemented hemiarthroplasty is the best alternative. This educational article suggests a treatment algorithm for FNFs and describes the evidence base for the recommended surgical techniques. Basicervical fractures, stress and pathological fractures are not included in this review.

摘要

股骨颈骨折（FNFs）在各年龄段均与功能丧失及死亡率增加相关。社会成本高昂。治疗需根据骨折类型、功能需求及患者生理年龄进行个体化调整。对于无移位的股骨颈骨折以及年轻患者的移位股骨颈骨折，通常首选内固定。解剖复位至关重要，但轻度外翻是可以接受的。对于大多数移位股骨颈骨折患者，骨水泥半髋关节置换术是最佳选择。这篇教育性文章提出了股骨颈骨折的治疗算法，并描述了推荐手术技术的循证依据。本综述不包括基底部骨折、应力性骨折和病理性骨折。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7aeb/12359207/69581b042d15/ActaO-96-44354-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7aeb/12359207/abcd5cf9766a/ActaO-96-44354-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7aeb/12359207/ec00661f4cdc/ActaO-96-44354-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7aeb/12359207/fe4830f10466/ActaO-96-44354-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7aeb/12359207/22c30e166825/ActaO-96-44354-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7aeb/12359207/69581b042d15/ActaO-96-44354-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7aeb/12359207/abcd5cf9766a/ActaO-96-44354-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7aeb/12359207/ec00661f4cdc/ActaO-96-44354-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7aeb/12359207/fe4830f10466/ActaO-96-44354-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7aeb/12359207/22c30e166825/ActaO-96-44354-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7aeb/12359207/69581b042d15/ActaO-96-44354-g005.jpg

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Clinical effectiveness of a modified muscle sparing posterior technique compared with a standard lateral approach in hip hemiarthroplasty for displaced intracapsular fractures (HemiSPAIRE): a multicenter, parallel-group, randomized controlled trial.改良保留肌肉后侧技术与标准外侧入路在髋关节半关节置换术治疗移位囊内骨折中的临床疗效比较（HemiSPAIRE）：一项多中心、平行组、随机对照试验
BMJ Surg Interv Health Technol. 2024 Jun 17;6(1):e000251. doi: 10.1136/bmjsit-2023-000251. eCollection 2024.
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A Comparison of Surgical Approaches for Hip Hemiarthroplasty Performed for the Treatment of Femoral Neck Fracture: A Systematic Review and Network Meta-analysis of Randomized Controlled Trials.髋关节半髋关节置换术治疗股骨颈骨折手术入路的比较：随机对照试验的系统评价和网络荟萃分析。
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