2021年AAOS《老年髋部骨折的治疗：基于循证的临床诊疗指南》解读

美国骨科医师协会发布了最新的《老年髋部骨折的治疗：基于循证的临床诊疗指南》是治疗老年髋部骨折重要的准则，与2014年治疗指南相比，新指南在编制规则和内容上均有较大变动。应用水泥型股骨柄治疗不稳定型股骨颈骨折、使用髓内钉固定不稳定型转子间骨折、采用氨甲环酸减少术中出血和输血，是过去7年中治疗老年髋部骨折的重要进步。在掌握老年髋部骨折诊疗指南的基础上，还应紧密结合患者的个体化特点，权衡好早期手术和手术安全性。解读《老年髋部骨折的治疗：基于循证的临床诊疗指南》有助于骨科医师了解老年髋部骨折治疗的进展，掌握诊疗要点，提高手术质量、降低围手术期并发症。

Interpretations of Management of Hip Fractures in Older Adults:Evidence-Based Clinical Practice Guideline dopted by AAOS 2021

American Academy of Orthopaedic Surgeons (AAOS) just released the up-to-date ,which has become the principles to care hip fractures in the elderly. In comparison to the Guideline 2014,considerable changes are made in terms of guideline composition and focused items. The interval of 7 years yielded dramatic progress in the care of geriatric hip fractures,including the recommendation of cemented femoral stems in hip arthroplasty due to displaced femoral neck fractures,cephalomedullary device for unstable intertrochanteric fractures and tranexamic acid to reduce blood loss and blood transfusion. Additionally,the individualized properties of the elderly with hip fractures should be noted to balance an early operation within 24 and 48 hours and patient safety. The interpretation of is helpful to comprehensively understand the progress of the care of geriatric hip fractures,thus to make orthopaedic surgeons master the key points of clinical practice,and to improve the quality of operations and decrease perioperative complications.