摘要
目的 对股骨转子间骨折外侧壁薄弱状态相关研究进展进行综述,为临床提供参考。方法 查阅近年来国内外股骨转子间骨折外侧壁相关研究文献,从形态学、冠状面骨折线、骨密度等方面进行总结分析。结果外侧壁薄弱状态评估对股骨转子间骨折治疗尤为重要。外侧壁厚度是评估外侧壁薄弱状态的主要方式,但仍存在问题。国内外学者从外侧壁宽度、高度、前皮质长度等多个方面展开研究,但目前尚缺乏综合评估方式。冠状面骨折会影响外侧壁形态,并且在X线片上难以发现,临床需要警惕。骨密度与外侧壁薄弱状态相关性亦有待进一步研究。小转子骨折块与外侧壁相互影响,小转子骨折会加重薄弱状态。外侧壁周围软组织也会影响薄弱状态,因此术中操作须重视对软组织的保护。结论 外侧壁薄弱状态评估方法较多,但未形成统一标准。目前研究大多从单一角度评估薄弱状态,缺乏对影响因素的综合性评估研究。对于外侧壁部分骨折后残余外侧壁功能的评估研究较少,也需要进一步完善。
Objective To review the research progress of the weak state of the lateral wall in intertrochanteric fracture,in order to provide clinical references.Methods The relevant research literature on the lateral wall of intertrochanteric fracture at home and abroad in recent years was summarized and analyzed in terms of morphology,fracture line in coronal plane,and bone density.Results Assessment of weak status of the lateral wall is particularly important in the treatment of intertrochanteric fractures.Lateral wall thickness is the main way to assess the weak state of the lateral wall,but there are still problems.Many scholars at home and abroad have studied various aspects such as width,height,and length of the anterior cortex,but there is a lack of a comprehensive assessment method.Coronal fractures affect lateral wall morphology and are difficult to detect on X-ray films,requiring vigilance on the part of the clinician.Further research is needed to clarify the correlation between bone density and the weak status of the lateral wall.The femur lesser trochanter fractures interacts with the latertal wall,and the lesser trochanter fracture exacerbates the weak state.The soft tissue around the lateral wall also affects the weak state,requiring intraoperative operation to pay attention to the protection of the soft tissue.Conclusion There are more methods for assessing the weak state of the lateral wall,but none of them has formed a unified standard.Most of the current studies assess the weak state from a single perspective and lack a comprehensive assessment of all aspects affecting the lateral wall.Fewer studies have been conducted to assess the residual lateral wall function after a partial fracture of the lateral wall,and further research is needed.
作者
张雅淳
付宇捷
吴斗
ZHANG Yachun;FU Yujie;WU Dou(Department of Orthopedic Surgery,Third Hospital of Shanxi Medical University,Shanxi Bethune Hospital,Shanxi Academy of Medical Sciences,Tongji Shanxi Hospital,Taiyuan Shanxi,030032,P.R.China)
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2024年第3期363-367,共5页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
股骨转子间骨折
外侧壁
薄弱状态
Intertrochanteric fracture
lateral wall
weak state
