老年患者的骨骨折:流行病学,病理机制,分类和治疗选择
Dietmar Krappinger1, Thomas Freude2, Fabian Stuby3
1Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
Archives of orthopaedic and trauma surgery
|May 18, 2024
概括
老年人骨骨折正在增加,通常影响男性,涉及前部结构. 治疗从非手术护理到内部固定或关节整形等各不相同,结果取决于骨折类型和缩小.
科学领域:
- 整形外科手术 整形外科手术
- 老年创伤的治疗方法
- 骨折 骨折 骨折 骨折 骨折 骨折
背景情况:
- 老年人骨骨折的发病率呈上升趋势,与年轻患者骨折的机制和常见骨折模式不同.
- 与其他骨质疏松性骨折不同,这些骨折主要影响男性,并且经常涉及前骨结构.
- 前列和后半截面 (ACPHT) 骨折是最常见的类型,通常呈现出超介质圆顶冲击 (标志).
研究的目的:
- 审查老年人骨骨折的流行病学,病理机制和治疗策略.
- 在这个患者群体中,比较非手术治疗,内置固定和关节整形术的结果和指示.
主要方法:
- 对老年人骨骨折的文献综述,重点关注发病率,人口统计和损伤机制.
- 分析当前的治疗方式,包括非手术治疗,开放式缩减和内部固定 (ORIF),以及初级关节整形.
- 评估影响治疗选择和结果的因素,如骨折模式,位移和患者特定情况.
主要成果:
- 老年人骨骨折越来越常见,男性占主导地位,与年轻患者相比,病理机制明显.
- 前侧骨结构和ACPHT模式经常参与其中,通常带有"标志".
- 非手术治疗适用于没有部脱或海标志的最小位移骨折;ORIF在解剖缩小方面取得了良好的结果;初级关节整形提供了立即的承重能力,避免了固定并发症.
结论:
- 老年人骨骨折的治疗决策必须考虑骨折的复杂性,患者因素和治疗的目标.
- 虽然ORIF可以成功,但初级关节整形是一个可行的替代方案,特别是在复杂的骨折,主要的挑战是acetabular杯固定.
- 最佳的管理需要仔细选择患者和量身定制的手术方法,可能将关节整形与内部固定技术结合起来.
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