青壮年股骨颈骨折系统诊治的研究进展

Research progress of systematic diagnosis and treatment of femoral neck fracture in young adults

青壮年股骨颈骨折并不常见,占此骨折类型的2%~3%,通常是由高能量创伤造成。往往骨折端血供破坏大,力学稳定性差,治疗失败率高。而青壮年患者对髋关节功能要求高,应优先考虑保存自身的关节解剖和恢复正常的关节功能。股骨头缺血和骨折复位固定的失效常导致骨不连和股骨头坏死。解剖复位和稳定的内固定是治疗的必要条件,但手术时机、复位方法、植入物的选择和固定方式等仍存在争议。本文将从青壮年股骨颈骨折的诊断及分型、股骨头血运、治疗方法、并发症处理等方面做一综述,为系统诊治此类型骨折提供参考。

Femoral neck fracture is not common in young adults,accounting for 2%~3%of this type of fracture,which is usually caused by high-energy trauma.Usually,the blood supply of fracture end is destroyed greatly,the mechanical stability is poor,and the treatment failure rate is high.However,young and middle-aged patients have high requirements for hip joint function.Therefore,priority should be given to preserving their own joint anatomy and restoring normal joint function.Femoral head ischemia and fracture reduction and fixation failure often lead to nonunion and necrosis of the femoral head.Anatomical reduction and stable internal fixation are the necessary conditions for treatment,However,the timing of operation,reduction method,selection of implants and fixation methods are still controversial.This article will review the diagnosis and classification of femoral neck fracture in young adults,blood supply of femoral head,treatment methods,complication treatment and so on,so as to provide reference for the systematic diagnosis and treatment of this type of fracture.