青壮年Pauwels III型股骨颈骨折内固定治疗的选择策略

Selection Strategies for Internal Fixation of Pauwels Type III Femoral Neck Fractures in Young Adults

青壮年Pauwels III型股骨颈骨折的治疗在骨科仍具有一定挑战,骨折多由高能量损伤引起,移位明显、创伤大,术后股骨头坏死的发生率仍很高。内固定植入物在不断地创新与改进,然而世界范围内仍无公认的“金标准”,选择何种内固定植入物对减轻患者经济和疼痛是临床亟需解决的问题。本文对青壮年股骨颈骨折的分型、手术入路和内固定方法的选择等做一综述,旨在为临床治疗此类骨折提供一些建议。

The treatment of Pauwels type III femoral neck fractures in young adults is still a challenge in or-thopedics. The fractures are mostly caused by high-energy injuries, with obvious displacement and large trauma. The incidence of postoperative femoral head necrosis is still high. Internal fixation implants are constantly innovating and improving, but there is still no recognized “gold standard” worldwide. It is an urgent clinical problem to choose which internal fixation implant can relieve the patient’s economy and pain. This article reviews the classification of femoral neck fractures in young and middle-aged adults, the selection of surgical approaches and internal fixation methods, and aims to provide some suggestions for the clinical treatment of such fractures.