股骨颈骨折内固定手术的研究历程与展望  

History and prospect of internal fixation operation of femoral neck fracture

作　　者：梅炯[1] 

机构地区：[1]同济大学附属同济医院创伤骨科,上海200065

出　　处：《中国骨与关节杂志》2015年第2期82-85,共4页Chinese Journal of Bone and Joint

基　　金：国家自然科学基金(81271991)

摘　　要：考古研究发现,远古人类的损伤类型多以采摘和狩猎相关的损伤多见,股骨颈骨折并不常见。德意志国王、神圣罗马帝国皇帝查理四世,也是在其死后600余年,才明确其直接死因是股骨颈骨折。时至今日,这种长期被冠以＂尚未解决的骨折＂仍有许多问题有待研究,如内固定与关节置换的选择,内固定的预后及判断等。现就股骨颈骨折内固定治疗的历史进行回顾,并探讨其发展中所存在的问题及今后研究设想。Femoral neck fracture is one of the major damages to health and life in the elderly population. But man has had his own understanding of that damage for only 600 years. The following research efforts had their milepost significance in the development of the internal fixation operation on femoral neck fracture. In 1858, a German surgeon, Von Langenbeck, did the first internal fixation of femoral neck fracture. But the patient unfortunately died of septicemia. In 1875, Franz Konig succeeded in the same operation with metal screws on disinfection. In 1883, Nicholass Senn, an American Surgeon, suggested that all femoral neck fractures should be treated with operation based on his animal experiments, but his proposal was not widely accepted. In 1931, Smith-Petersen etc. from the USA first published the results of open reduction and internal f ixation of femoral neck fracture with the use of trif in nail. In 1938, an American doctor, Henderson, publisized his results of the treatment of femoral neck fracture with cannulated screws in Mayo Clinic. In 1941, American Academy of Orthopaedic Surgeons（ AAOS） advocated the technique of trifin nail, which was pointed out to be unsuitable for the displaced femoral neck fracture by British Medical Research Council in 1976. Asnis cannulated screws appeared in 1980, which is still in use today. Fairly good effects have been achieved in the treatment of femoral neck fracture with internal fixation, but in some patients it still results in the necrosis of the femoral head. Thus, people are still making different choices between arthroplasty or internal fixation for the femoral neck fracture, depending largely on the surgeon＇s judgment on the degree of the impairment on blood supply to femoral head after the fracture and the influence of the impairment on its healing. The individualized choice of operation method, the maximal retainability of the femoral head blood supply, and the retaining of the residual blood supply from the impairment will be the focus in the future researc

关 键 词：股骨颈骨折 骨折固定术 内 骨折固定术 股骨颈 

分 类 号：R687.3[医药卫生—骨科学]