股骨转子间骨折的治疗进展

Progress in the treatment of intertrochanteric fracture

股骨转子间骨折是临床工作中一种常见的髋部骨折类型,既往数据显示该类型骨折占髋关节周围骨折的比例接近一半。罹患粗隆间骨折的患者人群多是老年人,致病原因多为低能量的摔倒。老年患者临床治疗相对积极,除非患者的合并症十分严重,因手术风险较高而无法耐受手术。积极的手术治疗是目前股骨转子间骨折首选的治疗方法,有助于患者早期开展下肢功能锻炼,早期开始下地负重功能锻炼,提高其活动能力。积极的手术治疗可有效避免因病长期卧床而导致的患者生活质量下降,甚至缩短预期寿命等严重不良后果。手术方式主要有髓外固定、髓内固定、髋关节置换等。本文旨在总结既往相关研究,回顾转子间骨折固定方法的差异,明确手术方案,进而提高手术效果,为临床工作提供一定参考。

Intertrochanteric fracture is a common type of hip fracture in clinical practice. Previous data showed that this type of fracture accounted for nearly half of the total hip fractures. Most of the patients with intertrochanteric fractures are elderly, and the cause of the disease is mostly low energy fall. The clinical treatment of elderly patients is relatively positive, unless the patient＇s complication is very serious and the operation is not tolerant because of the high risk of operation. Active surgical treatment is the preferred method to help patients with early development of lower limb function exercise, early weight-bearing functional exercise, improve their activity. Active surgical treatment can effectively avoid the adverse consequences such as the decline in the quality of life in patients due to a long stay in bed and even to shorten the life expectancy of patients. The main surgical methods were extramedullary fixation,intramedullary fixation, hip arthroplasty and so on. The purpose of this study is to summarize the previous studies, to review the differences in the methods of intertrochanteric fracture fixation, to clarify the surgical plan, and to improve the effect of the operation and to provide some reference for clinical work.