目的探讨Salter骨盆截骨联合股骨转子下旋转截骨治疗西藏低龄儿童Ⅲ、Ⅳ型发育性髋关节发育不良(development dysplasia of the hip,DDH)的临床疗效。方法回顾性收集2012年1月至2019年1月西藏自治区人民医院收治144例(144髋)DDH患儿,其...目的探讨Salter骨盆截骨联合股骨转子下旋转截骨治疗西藏低龄儿童Ⅲ、Ⅳ型发育性髋关节发育不良(development dysplasia of the hip,DDH)的临床疗效。方法回顾性收集2012年1月至2019年1月西藏自治区人民医院收治144例(144髋)DDH患儿,其中男31例,女113例;年龄18~68个月,平均(36.40±14.61)个月;按T9nnis分型,Ⅲ型64例,Ⅳ型80例;均行Salter骨盆截骨联合股骨转子下短缩、去旋转个性化截骨。研究手术前后髋臼指数(acetabular index,AI)、中心边缘角(center edge angle,CEA)变化以及术后髋关节功能Mckay等级、术后Severin影像学分型优良率、术后股骨头缺血性坏死(agasculal necrosis of the femoral head,ANFH)发生率。结果患儿术后随访13~53个月,平均(28.00±8.57)个月。末次随访时AI从术前(37.20±4.08)°恢复到(19.96±2.00)°,CEA从术前(-38.46±8.81)°恢复到(29.57±5.70)°;Mckay等级优良率88.19%,Severin影像学分型优良率91.66%,术后再脱位3例;术后ANFH 14例(9.72%),其中Ⅰ型12例(8.33%),Ⅱ型2例(1.38%)。结论Salter骨盆截骨联合股骨转子下旋转截骨治疗西藏低龄儿童Ⅲ、Ⅳ型DDH疗效肯定。展开更多
本研究旨在综述微创技术在老年股骨转子间骨折治疗中的最新进展,评估其临床效果及对患者预后的影响。通过系统检索近五年的国内外相关文献,分析了髓内固定和微创关节置换术在临床应用中的效果。近年来,髓内固定因其创伤小、恢复快,能够...本研究旨在综述微创技术在老年股骨转子间骨折治疗中的最新进展,评估其临床效果及对患者预后的影响。通过系统检索近五年的国内外相关文献,分析了髓内固定和微创关节置换术在临床应用中的效果。近年来,髓内固定因其创伤小、恢复快,能够显著提高内固定的稳定性并减少并发症,逐渐成为治疗首选。微创全髋关节置换术在特定患者群体中提供了长期稳定性,减少了再次手术需求,并显著提升了术后恢复质量。此外,手术时机对术后恢复和并发症发生率具有重要影响,早期手术干预能够显著改善患者预后,缩短卧床时间,减少并发症。综上所述,微创技术在老年股骨转子间骨折治疗中具有重要的临床应用价值,但仍需进一步优化技术、加强骨质疏松管理及开发个性化治疗方案,以提升患者的生活质量和术后功能恢复。This study aims to review the latest advancements in minimally invasive techniques for the treatment of intertrochanteric femoral fractures in the elderly, evaluating their clinical efficacy and impact on patient prognosis. By systematically retrieving and analyzing relevant domestic and international literature from the past five years, this review examines the clinical outcomes of intramedullary fixation and minimally invasive hip arthroplasty. In recent years, intramedullary fixation has gradually become the treatment of choice due to its minimal trauma, rapid recovery, enhanced stability of internal fixation, and reduced complications. Minimally invasive total hip arthroplasty provides long-term stability in appropriately selected patients, decreases the need for subsequent surgeries, and significantly improves postoperative functional recovery. Additionally, the timing of surgery plays a crucial role in postoperative recovery and the incidence of complications. Early surgical intervention can markedly improve patient prognosis, shorten bed rest duration, and reduce the occurrence of complications. In conclusion, minimally invasive techniques demonstrate significant clinical value in the treatment of intertrochanteric femoral fractures in the elderly. However, further optimization of surgical techniques, enhanced management of osteoporosis, and the development of personalized treatment plans are necessary to improve patients’ quality of life and postoperative functional recovery.展开更多
文摘目的探讨Salter骨盆截骨联合股骨转子下旋转截骨治疗西藏低龄儿童Ⅲ、Ⅳ型发育性髋关节发育不良(development dysplasia of the hip,DDH)的临床疗效。方法回顾性收集2012年1月至2019年1月西藏自治区人民医院收治144例(144髋)DDH患儿,其中男31例,女113例;年龄18~68个月,平均(36.40±14.61)个月;按T9nnis分型,Ⅲ型64例,Ⅳ型80例;均行Salter骨盆截骨联合股骨转子下短缩、去旋转个性化截骨。研究手术前后髋臼指数(acetabular index,AI)、中心边缘角(center edge angle,CEA)变化以及术后髋关节功能Mckay等级、术后Severin影像学分型优良率、术后股骨头缺血性坏死(agasculal necrosis of the femoral head,ANFH)发生率。结果患儿术后随访13~53个月,平均(28.00±8.57)个月。末次随访时AI从术前(37.20±4.08)°恢复到(19.96±2.00)°,CEA从术前(-38.46±8.81)°恢复到(29.57±5.70)°;Mckay等级优良率88.19%,Severin影像学分型优良率91.66%,术后再脱位3例;术后ANFH 14例(9.72%),其中Ⅰ型12例(8.33%),Ⅱ型2例(1.38%)。结论Salter骨盆截骨联合股骨转子下旋转截骨治疗西藏低龄儿童Ⅲ、Ⅳ型DDH疗效肯定。
文摘本研究旨在综述微创技术在老年股骨转子间骨折治疗中的最新进展,评估其临床效果及对患者预后的影响。通过系统检索近五年的国内外相关文献,分析了髓内固定和微创关节置换术在临床应用中的效果。近年来,髓内固定因其创伤小、恢复快,能够显著提高内固定的稳定性并减少并发症,逐渐成为治疗首选。微创全髋关节置换术在特定患者群体中提供了长期稳定性,减少了再次手术需求,并显著提升了术后恢复质量。此外,手术时机对术后恢复和并发症发生率具有重要影响,早期手术干预能够显著改善患者预后,缩短卧床时间,减少并发症。综上所述,微创技术在老年股骨转子间骨折治疗中具有重要的临床应用价值,但仍需进一步优化技术、加强骨质疏松管理及开发个性化治疗方案,以提升患者的生活质量和术后功能恢复。This study aims to review the latest advancements in minimally invasive techniques for the treatment of intertrochanteric femoral fractures in the elderly, evaluating their clinical efficacy and impact on patient prognosis. By systematically retrieving and analyzing relevant domestic and international literature from the past five years, this review examines the clinical outcomes of intramedullary fixation and minimally invasive hip arthroplasty. In recent years, intramedullary fixation has gradually become the treatment of choice due to its minimal trauma, rapid recovery, enhanced stability of internal fixation, and reduced complications. Minimally invasive total hip arthroplasty provides long-term stability in appropriately selected patients, decreases the need for subsequent surgeries, and significantly improves postoperative functional recovery. Additionally, the timing of surgery plays a crucial role in postoperative recovery and the incidence of complications. Early surgical intervention can markedly improve patient prognosis, shorten bed rest duration, and reduce the occurrence of complications. In conclusion, minimally invasive techniques demonstrate significant clinical value in the treatment of intertrochanteric femoral fractures in the elderly. However, further optimization of surgical techniques, enhanced management of osteoporosis, and the development of personalized treatment plans are necessary to improve patients’ quality of life and postoperative functional recovery.
