Kavanaugh J H
Orthop Clin North Am. 1981 Jan;12(1):165-74.
Some hip fractures in mentally deficient patients are days to weeks old, are not painful, and can be treated nonoperatively. Despite current emphasis on reduction an internal fixation of femoral neck fractures, displaced fractures (Garden IV) in this group should not be nailed. Impacted neck fractures (Garden I) should be pinned in situ and the patient should ambulate immediately. Hemiarthroplasty is the treatment of choice for displaced intracapsular fractures in those previously ambulatory. Late pain is not a clinical problem. Extracapsular fractures should be reduced and nailed with a sliding device in a valgus position without medial displacement, and the patient should ambulate immediately. Extended hospital stays for the purpose of physical therapy should be avoided. These people should be returned as soon as possible to their previous environment where graduated mobilization should be encouraged.
一些智力缺陷患者的髋部骨折已存在数天至数周，无疼痛症状，可采用非手术治疗。尽管目前强调股骨颈骨折的复位和内固定，但该组中的移位骨折（Garden IV型）不应进行髓内钉固定。嵌插型颈骨折（Garden I型）应原位固定，患者应立即开始活动。半髋关节置换术是既往能行走患者的囊内移位骨折的首选治疗方法。后期疼痛不是临床问题。囊外骨折应进行复位，并使用外翻位无内侧移位的滑动装置进行髓内钉固定，患者应立即开始活动。应避免为进行物理治疗而延长住院时间。这些患者应尽快回到其先前的环境中，并鼓励逐步进行活动。
