Objective To discuss the postoperative curative effects of two surgical techniques of minimally invasive total hip arthroplasty (THA) using metal-on-metal largediameter and conventional diameter femoral head for the e...Objective To discuss the postoperative curative effects of two surgical techniques of minimally invasive total hip arthroplasty (THA) using metal-on-metal largediameter and conventional diameter femoral head for the elderly patients展开更多
Femoral neck fractures account for nearly half of all hip fractures with the vast majority occurring in elderly patients after simple falls.Currently there may be sufficient evidence to support the routine use of hip ...Femoral neck fractures account for nearly half of all hip fractures with the vast majority occurring in elderly patients after simple falls.Currently there may be sufficient evidence to support the routine use of hip replacement surgery for low demand elderly patients in all but non-displaced and valgus impacted femoral neck fractures.However for the physiologically young patients,preservation of the natural hip anatomy and mechanics is a priority in management because of their high functional demands.The biomechanical challenges of femoral neck fixation and the vulnerability of the femoral head blood supply lead to a high incidence of non-union and osteonecrosis of the femoral head after internal fixation of displaced femoral neck fractures.Anatomic reduction and stable internal fixation are essentials in achieving the goals of treatment in this young patient population.Furthermore,other management variables such as surgical timing,the role of capsulotomy and the choice of implant for fixation remaincontroversial.This review will focus both on the demographics and injury profile of the young patient with femoral neck fractures and the current evidence behind the surgical management of these injuries as well as their major secondary complications.展开更多
With the advent of global aging,the incidence,mortality,and medical costs of hip fracture among aged patients are increasing annually.The number of controlled clinical studies and health economics analyses that confor...With the advent of global aging,the incidence,mortality,and medical costs of hip fracture among aged patients are increasing annually.The number of controlled clinical studies and health economics analyses that conform to evidence-based medicine principles is growing day by day.However,unfortunately,no specific recommendations regarding the procedures for the treatment of hip fracture are available.Meanwhile,the existence of both traditional treatment systems and new treatment theories means that most doctors confront difficult choices in their daily practice.These factors make the therapeutic approach for aged patients,especially among superaged patients with hip fracture,extremely challenging.This study focuses on superaged patients(>80 years as defined by the World Health Organization)with hip fracture and includes their preoperative pathological condition;therapeutic decision-making in terms of the benefit and risk ratio,damage control theory,and enhanced recovery after surgery were also investigated.These patients were discussed specifically by combining the current treatment strategies from several experts and the results of a meta-analysis published recently.The study presents some new ideas and approaches currently recognized in the field,such as preoperative assessment,surgical planning,safety consideration,complication intervention,and enhanced recovery implementation,and further presents some clear interpretations regarding misunderstandings in clinical practice.Finally,optimized treatment according to damage control principles and enhanced recovery after surgery during the perioperative period among superaged hip fracture patients is defined.展开更多
文摘Objective To discuss the postoperative curative effects of two surgical techniques of minimally invasive total hip arthroplasty (THA) using metal-on-metal largediameter and conventional diameter femoral head for the elderly patients
文摘Femoral neck fractures account for nearly half of all hip fractures with the vast majority occurring in elderly patients after simple falls.Currently there may be sufficient evidence to support the routine use of hip replacement surgery for low demand elderly patients in all but non-displaced and valgus impacted femoral neck fractures.However for the physiologically young patients,preservation of the natural hip anatomy and mechanics is a priority in management because of their high functional demands.The biomechanical challenges of femoral neck fixation and the vulnerability of the femoral head blood supply lead to a high incidence of non-union and osteonecrosis of the femoral head after internal fixation of displaced femoral neck fractures.Anatomic reduction and stable internal fixation are essentials in achieving the goals of treatment in this young patient population.Furthermore,other management variables such as surgical timing,the role of capsulotomy and the choice of implant for fixation remaincontroversial.This review will focus both on the demographics and injury profile of the young patient with femoral neck fractures and the current evidence behind the surgical management of these injuries as well as their major secondary complications.
基金Clinical research program of Xinqiao Hospital,Amy Medical University(grant no.2015YLC23)Technological Innovation and Application Demonstration Project of Chongqing(cstc2018jscx-msybX0051)。
文摘With the advent of global aging,the incidence,mortality,and medical costs of hip fracture among aged patients are increasing annually.The number of controlled clinical studies and health economics analyses that conform to evidence-based medicine principles is growing day by day.However,unfortunately,no specific recommendations regarding the procedures for the treatment of hip fracture are available.Meanwhile,the existence of both traditional treatment systems and new treatment theories means that most doctors confront difficult choices in their daily practice.These factors make the therapeutic approach for aged patients,especially among superaged patients with hip fracture,extremely challenging.This study focuses on superaged patients(>80 years as defined by the World Health Organization)with hip fracture and includes their preoperative pathological condition;therapeutic decision-making in terms of the benefit and risk ratio,damage control theory,and enhanced recovery after surgery were also investigated.These patients were discussed specifically by combining the current treatment strategies from several experts and the results of a meta-analysis published recently.The study presents some new ideas and approaches currently recognized in the field,such as preoperative assessment,surgical planning,safety consideration,complication intervention,and enhanced recovery implementation,and further presents some clear interpretations regarding misunderstandings in clinical practice.Finally,optimized treatment according to damage control principles and enhanced recovery after surgery during the perioperative period among superaged hip fracture patients is defined.
