手术治疗股骨粗隆下骨折的研究进展

Research Progress on Surgical Treatment of Subtrochanteric Fracture of the Femur

摘要: 粗隆下骨折是指股骨小粗隆和股骨干峡部之间的骨折，通常指的是股骨小粗隆以下5 cm以内的骨折，约占髋部骨折的25%。该类型骨折通常选择手术治疗，如果不进行手术复位和固定，患者出现畸形愈合或不愈合的风险将会很高。目前股骨粗隆下骨折手术方案主要有髓外固定及髓内固定两种，主流认为髓内固定是“金标准”。但由于股骨粗隆下区域特殊的解剖结构，特别是由于骨折处复位困难，粗隆下骨折的治疗对骨科医生来说仍然是一个巨大的挑战。本综述旨在介绍目前治疗股骨粗隆下骨折的手术方案及各自的优缺点，以为临床医生在股骨粗隆下骨折的治疗提供一定的参考。

Abstract: Subtrochanteric fracture refers to the fracture between the lesser trochanteric of the femur and the isthmus of the femoral shaft. It usually refers to the fracture within 5 cm below the lesser trochan-teric of the femur, accounting for about 25% of hip fractures. This type of fracture is usually treated with surgery. Without surgical reduction and fixation, patients are at high risk of malunion or non-union. At present, there are two main surgical options for subtrochanteric fractures of the fe-mur: extramedullary fixation and intramedullary fixation; intramedullary fixation is considered to be the “gold standard”. However, the treatment of subtrochanteric fractures is still a great challenge for orthopedic surgeons due to the special anatomical structure of the subtrochanteric region of the femur, especially due to the difficulty of reduction at the fracture site. The purpose of this review is to introduce the current surgical protocols for subtrochanteric fractures and their advantages and disadvantages, to provide some references for clinicians in the treatment of subtrochanteric frac-tures.