骨质疏松性粗隆间骨折的治疗进展

发布时间：2018-07-08 13:34

本文选题：骨质疏松 + 粗隆间骨折　；参考：《蚌埠医学院》2014年硕士论文

【摘要】：股骨粗隆间骨折常发生于老年人，最重要的原因之一是骨质疏松，老龄化问题在我国逐年加重，骨质疏松症已经成为60岁以上老年人非常常见的疾病，而这些人群如果发生轻微外伤，极易发生骨折。在治疗方面，可以采用保守治疗，虽然简单易行、创伤小，但并发症较多。大多数学者趋向于手术治疗，应用较早的是动力髋螺钉固定（DHS），随后又出现了锁定加压钢板（LCP）、在生物学固定技术涌现之后，出现了股骨近端髓内钉（PFN）,之后又改良成防旋股骨近端髓内钉（PFNA），为了弥补内固定的种种缺陷，还有部分学者应用人工股骨头置换（FHR）治疗股骨粗隆间骨折。在治疗骨折的同时，还应兼顾抗骨质疏松治疗。骨质疏松性粗隆间骨折的发病率有上升趋势，治疗方法多种多样，本文就该病在治疗方面作一综述。初步分析骨质疏松性粗隆间骨折患者，在治疗方法、手术方式、手术的适应症、手术疗效等方面的特点。众多的临床治疗经验，，给我们带来了一些启示：1)粗隆间骨折在骨质疏松人群中的发生率远高于正常人群。2）术前应对病人进行全面而充分的评估。如病人对麻醉及手术的耐受能力、手术时机的选择、固定方法的选择。3）术前至术后持续采用有效药物治疗骨质疏松，不仅有利于骨折的愈合，而且还可以预防骨质疏松性骨折的再次发生。4）本院近几年治愈了多例骨质疏松性股骨粗隆间骨折患者，获得经验：在治疗骨折的同时，若配合抗骨质疏松药物，可显著提高疗效。
[Abstract]:Femoral intertrochanteric fracture often occurs in the elderly. One of the most important reasons is osteoporosis. The problem of aging is worsening year by year in our country. Osteoporosis has become a very common disease in the elderly over 60 years old. These people are vulnerable to fractures if they have minor injuries. In treatment, conservative treatment can be used, although simple, less trauma, but more complications. Most scholars tend to operate, using DHS earlier, then locking compression plates (LCP), after the emergence of biological fixation techniques. The proximal femoral intramedullary nail (PFN) appeared, and then improved to anti-rotation proximal femoral nail (PFNA). In order to remedy the defects of internal fixation, some scholars used artificial femoral head replacement (FHR) to treat intertrochanteric fracture of the femur. In the treatment of fracture, should also take into account the treatment of anti-osteoporosis. The incidence of osteoporotic intertrochanteric fracture is on the rise and the treatment methods are varied. This article reviews the treatment of osteoporosis intertrochanteric fracture. The characteristics of the patients with osteoporotic intertrochanteric fracture were analyzed in terms of treatment methods, surgical methods, indications and curative effects. Many clinical experiences have brought us some enlightenment: (1) the incidence of intertrochanteric fracture in osteoporosis population is much higher than that in normal population (.2) the patients should be evaluated comprehensively and fully before operation. For example, the patient's tolerance to anesthesia and surgery, the choice of operation timing, the choice of fixation method, and the choice of 3) effective medication to treat osteoporosis before and after operation is not only beneficial to fracture healing, but also to the treatment of osteoporosis. In recent years, our hospital has cured many patients with osteoporotic femoral intertrochanteric fractures. Experience has been gained: in the treatment of fractures, if combined with anti-osteoporosis drugs, It can significantly improve the curative effect.
【学位授予单位】：蚌埠医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R683

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