摘要
目的介绍保守治疗、内固定、人工关节置换术和多学科综合诊疗(multidisciplinary team,MDT模式等治疗老年股骨颈骨折的研究进展。方法广泛查阅国内、外近年相关文献,对多种老年股骨颈骨折治疗方法、新治疗模式的特点和应用进行总结分析。结果老年非移位型股骨颈骨折应手术治疗,保守治疗继发移位风险高。移位型骨折则应尽早进行手术,人工半髋、全髋关节置换术后患者的远期功能结果没有差别。人工半髋关节置换术中出血量少、手术时间短,适合基础情况不佳的高龄患者;人工全髋关节置换术适合基础情况较好、对生活质量要求较高的老年患者。MDT可有效减少患者术前等待时间和住院时间、降低内科并发症发生率、改善患者营养状况和降低患者死亡率。结论内固定、人工关节置换术等术式和MDT新模式用于老年股骨颈骨折的治疗均取得了显著成果。
Objective To introduce the research progress of conservative treatment, internal fixation, hip arthroplasty, and multidisciplinary team(MDT) modes in the treatment of femoral neck fracture in the elderly.Methods By consulting domestic and foreign literature in recent years, the characteristics and application of various treatment methods and new treatment modes for femoral neck fracture in the elderly were summarized and analyzed.Results The elderly non-displaced femoral neck fracture should be treated surgically, and conservative treatment has a high risk of secondary displacement. The displaced fracture should be operated as soon as possible. There is no difference in long-term functional outcome between hemiarthroplasty and total hip arthroplasty. Hemiarthroplasty has less intraoperative blood loss, shorter operation time, and is suitable for the elderly patients with poor basic condition. Total hip arthroplasty is suitable for the elderly patients with better basic condition and higher demand of life quality. MDT can effectively reduce preoperative waiting time and length of stay, reduce the incidence of medical complications, improve the nutritional status of patients, and reduce the mortality of patients. Conclusion Significant results have been achieved in the treatment of femoral neck fractures in the elderly by methods such as internal fixation, hip arthroplasty, and MDT.
作者
周洋洋
倪英杰
李荥娟
陈辉
芮云峰
ZHOU Yangyang;Nl Yingjie;LI Xingjuan;CHEN Hui;RUI Yunfeng(Department of Traumatic Orthopaedics,Zhongda Hospital,School of Medicine,Southeast University,Nanjing Jiangsu,210009,P.R.China;Institute of Traumatic Orthopaedics,School of Medicine,Southeast University,Nanjing Jiangsu,210009,P.R.China;Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management,Zhongda Hospital,School of Medicine,Southeast University,Nanjing Jiangsu,210009,P.R.China;Trauma Center,Zhongda Hospital,School of Medicine,Southeast University,Nanjing Jiangsu,210009,P.R.China;Department of Orthopaedics,Xishan People's Hospital of Wuxi,Wuxi Jiangsu,214105,P.R.China;Department of Orthopaedics,Wuxi Branch of Zhongda Hospital,School of Medicine,Southeast University,Nanjing Jiangsu,214105,P.R.China;Department of Geriatrics,Zhongda Hospital,School of Medicine,Southeast University,Nanjing Jiangsu,210009,P.R. China)
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2019年第8期1033-1040,共8页
Chinese Journal of Reparative and Reconstructive Surgery
基金
江苏省科教强卫医学重点人才项目(ZDRCA2016083)
无锡市科技发展资金/医疗与公共健康项目(WX18IIAN442)
南京市科学与技术委员会软科学研究计划项目(2016ZD014)
瑞华慈善基金资助项目~~
关键词
股骨颈骨折
保守治疗
内固定
人工关节置换术
多学科综合诊疗
老年患者
Femoral neck fracture
conservative treatment
internal fixation
hip arthroplasty
multidisciplinary team
elderly patient
