股骨转子间骨折不同外侧壁分型的内固定治疗策略  

Internal fixation strategies for different lateral wall types of intertrochanteric fractures of the femur

作　　者：郭天庆 薛飞[1] 冯卫[1] Guo Tianqing;Xue Fei;Feng Wei(Second Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010000,Inner Mongolia Autonomous Region,China)

机构地区：[1]内蒙古医科大学第二附属医院

出　　处：《中国组织工程研究》2020年第6期917-923,共7页Chinese Journal of Tissue Engineering Research

基　　金：内蒙古自治区高等学校科学研究项目(NJZZ14143)，蒙古族人群数字化股骨近端三维有限元模型建立及其股骨粗隆间骨折理想化髓内固定系统设计研究，项目负责人：冯卫~~

摘　　要：背景:股骨转子外侧壁在股骨转子间骨折中的重要性受到越来越多的重视,对外侧壁的分型进行研究对临床手术的指导意义逐渐成为热点问题。目的:综述股骨转子间骨折不同外侧壁分型的治疗策略,以及内置物的选择优劣,为以后的临床研究提供参考与帮助。方法:由第一作者应用计算机检索万方、知网中文数据库,检索词为"股骨粗隆间骨折;股骨转子间骨折;股骨粗隆外侧壁;骨折分型;骨折固定术,内;内置物;髓内固定;髓外固定;并发症;老年人;预后"。同时检索PubMed英文数据库,检索词为"Intertrochanteric fracture of femur;lateral wall of femoral trochanter;fracture classification;fracture fixation, internal;implant;intramedullary fixation;extramedullary fixation;complications;elderly;prognosis"。检索时限为2009年5月到2019年5月。共检索到文献数量为166篇,根据纳入标准及排除标准,最终选择47篇文献作为研究对象并进行综述。结果与结论:①在手术治疗股骨转子间骨折的过程中,髓内固定系统与髓外固定系统各有其优势与不足,充分分析股骨转子外侧壁分型并做好合理的术前评估,将理论与实践相结合,积极把控手术指征、正确评估骨折严重程度及判断预后,对患者的治疗效果及预后有很大的帮助;②根据患者的经济条件及身体素质制定出不同的治疗方案,是医生的基本素质也是对患者负责任的态度,"个体化"已经成为未来发展趋势;③股骨转子间骨折的治疗仍然存在较多争议,未来需要更多的临床研究及数据支持来解决与完善。BACKGROUND: The importance of the lateral wall of the femoral trochanter in the intertrochanteric fracture has been paid more and more attention. The research on the classification of the external wall in guiding clinical operation has become a hot issue. OBJECTIVE: To review the treatment strategies of different lateral wall types of intertrochanteric fractures, and the selection of the built-in materials, provide reference and help for future clinical research. METHODS: The first author searched the Chinese database of Wanfang and China National Knowledge Infrastructure with the keywords of "intertrochanteric fracture of femur;lateral wall of femoral trochanter;fracture classification;fracture fixation, internal;implant;intramedullary fixation;extramedullary fixation;complications;elderly;prognosis". Meanwhile, PubMed English database was retrieved with the keywords "intertrochanteric fracture of femur;lateral wall of femoral trochanter;fracture classification;fracture fixation, internal;implant;intramedullary fixation;extramedullary fixation;complications;elderly;prognosis". The retrieval time was from May 2009 to May 2019. A total of 166 literatures were retrieved. According to the inclusion and exclusion criteria, 47 literatures were selected as the research object and summarized. RESULTS AND CONCLUSION:(1) During the surgical treatment of intertrochanteric fracture of the femur, intramedullary fixation system and extramedullary fixation system have their own advantages and disadvantages. After full analysis of lateral femoral trochant er wall classification and reasonable preoperative evaluation, it is a combination of theory and practice. Signing, correctly assessi ng the severity of fractures and judging the prognosis, and fully preoperative evaluation can greatly help the patient’s treatment effect and prognosis.(2) It is a basic quality of doctors and a responsible attitude towards patients to formulate different treatment plans according to their economic conditions and physical qualities. "Individua

关 键 词：股骨转子间骨折 外侧壁 髓内固定 髓外固定 动力髋螺钉 股骨近端防旋髓内钉 股骨近端锁定钢板 大转子稳定板 经皮加压钢板 

分 类 号：R459.9[医药卫生—治疗学] R683.42[医药卫生—临床医学]