AO／OTA-2018版股骨转子间骨折分类的解读与讨论  

Interpretation of and discussion on AO/OTA-2018 fracture classification of femoral per/in-ter-trochanteric fractures

作　　者：张世民 余斌[2] Zhang Shimin;Yu Bin(Department of Orthopaedic Trauma,Yangpu Hospital,Tongji University,Shanghai 200090,Chin;Department of Orthopaedic Trauma,Nanfang Hospital,Southern Medical University,Guangzhou 510515,Chin)

机构地区：[1]同济大学附属杨浦医院骨科,上海200090 [2]南方医科大学附属南方医院创伤骨科,广州510515

出　　处：《中华创伤骨科杂志》2018年第7期583-587,共5页Chinese Journal of Orthopaedic Trauma

基　　金：国家自然科学基金（81772323）

摘　　要：骨折分类的价值在于准确描述骨折特征、反映损伤程度、指导治疗方法选择和帮助判断预后。AO／OTA骨折分类系统（1996第一版、2007第二版）在世界范围内被广泛接受。2018年发布的第三版修订版，对股骨转子间骨折的分类进行了彻底更新，采用外侧壁为第二级分类指标（不再采用小转子骨块），为临床内固定选择髓外侧板系统（以DHS为代表）还是髓内系统（头髓钉）提供了明确的指导。该分类系统简明扼要、实用性强，本文将对其进行解读和讨论，如能增JJI-~维影像立体资料，则分类的准确性和观察者一致性将有大幅提高。The value of fracture classification lies in describing fracture features, representing injury severity, guiding treatment choice and predicting outcomes. The OA/OTA fracture classifications system （its first edition in 1996 and its second edition in 2007） is accepted worldwide. Its third revised edition published in 2018 has completely renewed the classification of femoral per/inter-trocbanteric fractures, in which the cortical lateral wall is used as the secondary key element to replace the former lesser trochanter. The new classification gives clear directions for selecting extramedullary side-plate fixation （e. g. dynamic hip screw, DHS） for intact lateral wall （31A 1 ） and intramedullary nailing （cephalomedullary nail） for vulnerable （31A2） or broken lateral wall （31A3） . This paper will interpret and discuss the new classification. We believe that this classification system will be more accurate with high inter/intra-observer agreement if more 3D-CT images are supplemented.

关 键 词：髋 骨折 内固定器 股骨转子间骨折 骨折分类 AO/OTA学会 

分 类 号：R683[医药卫生—骨科学]