不稳定型股骨粗隆间骨折的诊疗进展

Advances in Diagnosis and Treatment of Unstable Intertrochanteric Fractures

股骨粗隆间骨折常发生于高龄人群,由于高龄人群多合并骨质疏松症,肢体活动不灵活,直接或间接暴力易造成此类骨折,其发生率随时间推移而逐渐升高。此类患者体质较弱,且伴随有高血压、糖尿病、肺部疾病、心脑血管疾病等内科疾病,因此该类患者存在以上高危因素,不能采取保守治疗,因为保守治疗比手术治疗有更高的病死率及致残率,此类骨折的治疗目的包括及时治疗、股骨骨折断端的功能复位、早期康复锻炼治疗。目前临床上治疗此类骨折有多种方式,如髓外固定术、髓内固定术和髋关节置换,每个手术方式的治疗效果也存在差异,InterTAN是改良的第四代髓内钉,该手术方式逐渐走进临床。本综述主要目的是阐述目前诊疗股骨粗隆间骨折(不稳定型)的进展。

Intertrochanteric fractures often occur in the elderly population.Because the elderly population is often complicated with osteoporosis and their limbs are not flexible,direct or indirect violence is easy to cause such fractures,and its incidence gradually increases with time.Such patients are weak in constitution and accompanied by medical diseases such as high blood pressure,diabetes,lung disease,and cardiovascular and cerebrovascular diseases.Because these patients have the above high-risk factors,conservative treatment cannot be adopted,because conservative treatment has a higher mortality and disability rate than surgical treatment.The goals of treatment for such fractures include timely treatment,functional restoration of the femoral fracture,and early rehabilitation and exercise.At present,there are many ways to treat such fractures clinically,such as extramedullary fixation,intramedullary fixation,and hip replacement.The treatment effect of each surgical method is also different.InterTAN is an improved fourth-generation intramedullary nail.This surgical approach is gradually entering the clinic.The main purpose of this review is to describe the current progress in the diagnosis and treatment of intertrochanteric fractures(unstable).