Obrant K
Department of Orthopedics, University Hospital, Malmö, Sweden.
Bone. 1996 Mar;18(3 Suppl):145S-148S. doi: 10.1016/8756-3282(95)00495-5.
There are those who advocate nonoperative treatment of impacted femoral neck fractures, but in general there is consensus that surgery is the treatment of choice for both trochanteric hip fracture and femoral neck fracture. As for trochanteric fractures, modern results after internal fixation are characterized by only a low percentage of secondary operations, even for unstable fractures and when full weight bearing is permitted immediately after operation. The high rates of complication after internal fixation of femoral neck fractures and the insignificant improvement of these results over the decades have made prosthetic replacement an alternative method of treatment, at least for dislocated femoral neck fractures. Until a quantifiable prognostic method to judge whether a given femoral neck fracture will heal is available, and until sufficiently large, prospective techniques have been undertaken, diverging opinions about the operative treatment of choice will persist.
有些人主张对嵌插型股骨颈骨折采取非手术治疗，但总体而言，对于转子间髋部骨折和股骨颈骨折，手术是首选的治疗方法这一点已达成共识。对于转子间骨折，内固定术后的现代结果表现为二次手术的比例较低，即使是不稳定骨折且术后立即允许完全负重的情况下也是如此。股骨颈骨折内固定术后的高并发症发生率以及几十年来这些结果的改善不显著，使得假体置换成为一种替代治疗方法，至少对于脱位的股骨颈骨折是这样。在有可量化的预后方法来判断某一给定股骨颈骨折是否会愈合之前，以及在尚未开展足够大样本的前瞻性研究之前，关于首选手术治疗的不同观点将持续存在。
