股骨近端外侧壁厚度及其临床意义

Lateral wall thickness of the proximal femur and its clinical significance

自2004年Gotfried提出股骨近端外侧壁概念以来,骨科临床医师对这种结构的认识越来越深入。股骨近端骨折外侧壁破裂会导致内固定失败,影响功能恢复,甚至需要翻修手术。外侧壁对内固定术后的稳定性起着重要作用,是决定手术成功与否的关键因素。完整的侧壁可以防止一些术后并发症,例如股骨头颈部骨折碎片的侧向移位,螺旋刀片切割股骨头和髋内翻。外侧壁厚度是目前评价外侧壁完整性的客观参数,也视为选择内固定技术的指标。本文对外侧壁及其厚度的意义进行综述,以供临床医师参考。

Since the concept of the lateral wall of proximal femoral proposed by Gotfried in 2004, orthopaedic clinicians have gained more and more profound understanding of this structure. Rupture of the lateral wall in proximal femoral fractures will lead to failure of internal fixation, impact function recovery, even need revision surgery. The lateral wall plays an important role in the stability after internal fixation and is the key factor to determine the success of the operation. An intact lateral wall prevents some postoperative complications, such as the lateral displacement of the head and neck fracture fragments, femoral head cut by the spiral blade and coxa vara. The thickness of the lateral wall is an objective parameter for the evaluation of the integrity of the lateral wall at present, and also serves as a guide for the selection of internal fixation techniques. In this paper, the definition of lateral wall and clinical significance of its thickness was reviewed in order to provide a reference for clinicians.