内侧壁破坏老年股骨转子间骨折分型及恢复骨性支撑和骨皮质的连续性  

Classification of intertrochanteric fractures with medial wall destruction in elderly patients and recovery of bony support and continuity of the cortical bone

作　　者：许晓沛 吕欣[1] Xu Xiaopei;LüXin(Department of Orthopedics,the Second Hospital of Shanxi Medical University,Taiyuan 030001,Shanxi Province,China)

机构地区：[1]山西医科大学第二医院骨科,山西省太原市030001

出　　处：《中国组织工程研究》2021年第14期2259-2265,共7页Chinese Journal of Tissue Engineering Research

摘　　要：背景:伴有内侧壁损伤的股骨转子间骨折是一类常见的转子间骨折类型。由于内侧壁骨皮质承担着股骨近端主要的力学传导,在临床中对此类损伤的分型及治疗方式在不断改进。目的:通过对伴有内侧壁损伤的股骨转子间骨折的骨折分型、损伤机制及力学研究进行分析,对不同的内固定治疗方式进行归纳总结,为此类骨折治疗提供帮助。方法:通过检索CNKI、万方、PubMed、Web of Science等中英文数据库,中文检索词为"股骨转子间骨折,内侧壁,内固定",英文检索词为"intertrochanteric fracture,femoral intertrochanteric fracture,medial wall,fracture fixation"。通过纳入标准与排除标准,将最终纳入的文献进行归纳、总结。结果与结论:股骨转子间内侧壁骨皮质承担着股骨近端主要的压力传导,股骨矩尤为重要。常见的骨折分型有Evans分型、Jensen分型、AO/ATO分型、Kyle分型、Muller ME分型等,对内侧壁损伤骨折治疗有明确的指导意义。对于内侧壁破坏的老年股骨转子间骨折的治疗,采用何种内固定治疗方式尚无统一的观点,需根据内侧壁稳定情况及老年患者基础情况进行最佳选择,但可明确的是对于不稳定型内侧壁损伤的老年患者,应首先恢复内侧壁骨性支撑及皮质的连续性。BACKGROUND:Intertrochanteric fracture with medial wall injury is a common type of intertrochanteric fracture.Since the medial parietal cortex is responsible for the major mechanical conduction of the proximal femur,the classification and treatment of such injuries have been updated in clinical practice.OBJECTIVE:Through the analysis of the fracture classification,injury mechanism and mechanics of intertrochanteric fracture with medial wall injury,to summarize the different internal fixation treatment methods,thereby providing help for the treatment of this kind of fracture.METHODS:CNKI,WanFang,PubMed and Web of Science database were searched using"intertrochanteric fracture,femoral intertrochanteric fracture,medial wall,fracture fixation"in Chinese and English,respectively.According to the inclusion and exclusion criteria,eligible literatures were included for final analysis and review.RESULTS AND CONCLUSION:The medial parietal cortex of the intertrochanter bears the main pressure conduction of the proximal femur,and the calcar femorale is particularly important.The common fracture types include Evans type,Jensen type,AO/ATO type,Kyle type and Muller ME type,which are of guiding significance for fractures with medial wall injury.For the treatment of intertrochanteric fractures with medial wall injury in the elderly,there is no unified view on which internal fixation method is used.The best choice of internal fixation needs to be made according to the stability of the medial wall and the basic condition of elderly patients.However,for elderly patients with unstable medial wall injury,we should first restore the continuity of the cortex and bony support to the medial wall.

关 键 词：骨股骨转子 股骨 骨折 内侧壁 内固定 髓内固定 髓外固定 

分 类 号：R459.9[医药卫生—治疗学] R496[医药卫生—临床医学]