高龄患者股骨粗隆间骨折的治疗研究进展

Progress in the treatment of intertrochanteric fracture of femur in elderly patients

随着人口老龄化的增长,股骨粗隆间骨折的发病率也逐渐上升,在美国,每年有超过20万人发生这种骨折,而死亡率从15%上升到了30%,预计到2025年,全球年均发病人数将达到260万~460万,且不稳定型骨折增多。治疗包括保守治疗、手术治疗。保守治疗周期相对较长,易出现并发症,比如:髋内旋、髋内翻、肌肉萎缩、肢体短缩、畸形等不良现象,以及老年患者在治疗期间因需长期卧床休养,易呈现泌尿系统感染、褥疮、坠积性肺炎、下肢静脉血栓及关节僵硬挛缩等并发症。正因保守治疗有如此多的缺点,手术措施越来越成为医治股骨粗隆间骨折的首选方法。本文对近年来我国高龄患者股骨粗隆间骨折的治疗进行综述。

With the increase of population aging,the incidence of intertrochanter fracture of femur is also gradually increasing.In the United States,more than 200 000 people have this fracture every year,and the mortality rate has risen from 15%to 30%.It is pedicted that by 2025 year,the average annual incidence of intertrochanter fracture will reach 2.6 million to 4.6 million,and the number of unstable fractures will increase.Treatment of intertrochanter fracture includes conservative treatment and surgical treatment.Conservative treatment cycle is relatively long,prone to complications,such as hip rotation,hip varus,muscle atrophy,limb shortening,deformity and other adverse phenomena.The elderly patients due to stay in bed for a long time during the treatment,prone to urinary system infection,bedsore,falling pneumonia,lower extremity venous thrombosis and joint stiffness contracture and other complications.Because of so many shortcomings of conservative treatment,surgical treatment is becoming the first choice for the treatment of intertrochanter fracture of femur.In this paper,the treatment of inter-trochanteric fracture of femur in elderly patients in China in recent years is reviewed.