老年人股骨颈骨折内固定治疗的研究进展

内固定治疗老年人股骨颈骨折,尤其空心钉的应用,较髋关节置换具有微创、经济、操作简便的优势,成为近年来骨科临床研究的热点.空心钉的构型问题仍存在争议,大多数临床医生认为3枚空心钉平行置入的倒三角构型固定方法在生物力学及临床效果方面优于正三角构型,而非平行的强斜置钉技术能使螺钉分担更多体重,减少术后并发症,更适用于老年骨质疏松患者.内固定治疗股骨颈骨折术后骨不连、股骨颈短缩等难题仍是国内外学者关注的焦点.如何把握内固定手术的适应证,了解并发症的相关因素,预防并发症的发生有待进一步探索.

Advances on internal fixation treatment for femoral neck fracture in elderly patients

Compared with hip replacement,internal fixation in the treatment of the elderly femoral neck fracture,especially the application of cannulated screws,is minimally invasive,easy to operate and economical. In recent years,it becomes the research focus in the field of orthopedic clinical research. However,configuration of cannulated screws is still controversial. Most clinicians believe that three cannulated screws being placed in parallel in an inverted triangle configuration is better than that in a triangular configuration in biomechanics and clinical effect. Nonparallel strong oblique nailing technique allows the screws to share more weight to reduce postoperative complications,so that it is more suitable for elderly patients with osteoporosis. However,the related complications of internal fixation such as nonunion,femoral neck shortening and other problems are still the focus of domestic and foreign scholars. Issues about how to control the indication of internal fixation surgery,understand related factors of the complications,and prevent complications are required to be further explored.