Perez E D
Department of Internal Medicine, Medical College of Virginia, Richmond.
Geriatrics. 1994 Apr;49(4):31-7.
The typical hip fracture patient is a woman over the age of 65, and the primary risk factor is trabecular bone loss and diminished bone strength related to postmenopausal osteoporosis. Medical stabilization before surgery is an absolute requirement, and surgical repair may be delayed up to 7 days with no adverse effect on outcome. If the choice between conservative medical management or surgical repair is close, surgical repair almost always gives better results. Surgeons choose from among four types of hip repair surgery: pinning, placement of a nail, fixation, and arthroplasty. Potential postoperative complications include DVT and PE, pressure ulcers, delirium, UTIs, and wound infection. Early mobilization is imperative to the primary objectives of maximizing functional independence while preventing secondary complications.
典型的髋部骨折患者是65岁以上的女性，主要危险因素是与绝经后骨质疏松症相关的小梁骨丢失和骨强度下降。手术前进行医学稳定处理是绝对必要的，手术修复可推迟长达7天，且对结果无不利影响。如果在保守药物治疗和手术修复之间的选择比较接近，手术修复几乎总是能取得更好的效果。外科医生可从四种髋部修复手术中选择：打钉、髓内钉置入、固定和关节成形术。术后潜在的并发症包括深静脉血栓形成和肺栓塞、压疮、谵妄、尿路感染和伤口感染。早期活动对于实现最大限度提高功能独立性同时预防继发性并发症的主要目标至关重要。
