关节置换术治疗不稳定粗隆间骨折重建大粗隆稳定性的方法研究

Reconstruction of Greater Trochanteric Stability by Joint Replacement for Unstable Intertrochanteric Fracture

摘要: 随着我国人口老龄化的加重，股骨粗隆间骨折的发生率逐渐上升，患者常见于伴有严重骨质疏松及其他并发症，故应积极早期手术治疗。人工关节置换术适用于不稳定性股骨粗隆间骨折，同时伴有严重骨质疏松。对于不稳定股骨粗隆间骨折行关节置换术，重建大粗隆，以确保外展肌臂的连续性是非常重要的，目前重建大粗隆的方法很多，但重建大粗隆的最佳方法仍然存在争议，故本文主要收集现有文献，以归纳总结目前人工髋关节置换术治疗股骨粗隆间骨折中重建大粗隆的方法，探究何种方法最佳。结论：钢丝布线技术操作简单、技术成熟以及成本较低，适合常规的股骨粗隆间骨折固定大粗隆以重建其稳定性，而对于复杂的情况，类似于翻修全髋关节置换术，应该结合患者实际情况，综合评估，选择个体化的固定方法重建大粗隆稳定性。

Abstract: With the aggravation of aging population in our country, the incidence of intertrochanteric fracture of femur has been increasing gradually, the patients are often accompanied by serious osteoporosis and other complications, so early operation should be conducted. Artificial joint replacement is recommended for unstable intertrochanteric fractures of the femur with severe osteoporosis. For unstable intertrochanteric fracture of femur, joint replacement and reconstruction of greater tro-chanter are very important to ensure the continuity of abductor arm. Currently, there are many ways to reconstruct greater trochanter, but the best way to reconstruct greater trochanter is still controversial. Therefore, this paper mainly collected existing literature to summarize the current methods of reconstruction of greater trochanter in the treatment of intertrochanteric fracture of femur with artificial hip replacement and explore which method is best. Conclusion: With simple operation, mature technology and low cost, wire wiring technique is suitable for conventional inter-trochanteric fracture fixation of the greater trochanter to reconstruct its stability. For complex cases, similar to revision total hip replacement, it should be combined with the actual situation of patients, comprehensive evaluation, and select individualized fixation method to reconstruct the stability of the greater trochanter.