Zickel R E
Clin Orthop Relat Res. 1980 Mar-Apr(147):93-114.
A review and appraisal of current methods of treatment of fractures of the femur including operative and nonoperative methods as well as complications or limitations of various methods, reveals that a specific appliance or procedure is of value only when used with proper indication and proper technique. When internal fixation is performed, load-sharing between appliance and bone is mandatory, because of the large mechanical stresses involved. Intramedullary fixation permits load-sharing more often than extramedullary fixation and should be used on femoral fractures whenever possible. Conservative management with traction and braces can be valuable for young patients with fracture of the distal femur, but requires careful technique and follow-up to avoid excessive shortening or deformity. The proximal, middle and distal part of the femur should be evaluated separately as each area has specific anatomic limiations and biomechanical requirements.
对当前股骨骨折治疗方法的回顾与评估，包括手术和非手术方法以及各种方法的并发症或局限性，结果表明，一种特定的器械或手术只有在有适当指征并采用适当技术时才具有价值。当进行内固定时，由于涉及巨大的机械应力，器械与骨骼之间的负荷分担是必不可少的。髓内固定比髓外固定更常允许负荷分担，并且只要有可能，就应将其用于股骨骨折。对于股骨远端骨折的年轻患者，牵引和支具的保守治疗可能有价值，但需要仔细的技术操作和随访，以避免过度缩短或畸形。股骨的近端、中部和远端应分别评估，因为每个区域都有特定的解剖学限制和生物力学要求。
