Concurrent ipsilateral fractures of the hip and femoral shaft - A meta-analysis of 659 cases
Concurrent ipsilateral fractures of the hip and femoral shaft - A meta-analysis of 659 cases
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DOI：
10.3109/17453679608995603
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发表时间：
1996-02-01
期刊：
影响因子：
--
通讯作者：
Alho, A
中科院分区：
文献类型：
--
作者：
Alho, A
对 59 项研究中报告的 659 例同时发生的同侧髋部和股骨干骨折进行了分析。 78% 的患者是因道路交通事故造成的，13% 的患者是因其他类型的高能量创伤造成的。这种损伤组合在儿童中很少见。中位年龄为 34 岁。 78%的患者是男性。三分之一的人有多处受伤，一半的人有同侧膝盖受伤，一半的人有其他下肢受伤。股骨颈骨折最常见的是基底骨折，据报道股骨颈骨折发生率为 3%。转子骨折为转子间横行骨折，很少发生粉碎性骨折。降低发病率的重要因素是所有损伤的早期诊断和干骨折的有效治疗。锁定髓内钉的效果优于钢板或未锁定髓内钉与单独髋螺钉的组合。重建钉（头髓钉）的结果与传统锁定钉和单独髋螺钉的结果相同。髋部骨折的愈合率超过99%，其中骨干骨折的治疗对于结果至关重要。
659 cases of concurrent, ipsilateral fractures in the hip and femoral shaft reported in 59 studies were analyzed. The causes were a road traffic accident in 78% and other types of high-energy traumas in 13% of the patients. This injury combination was rare in children. The median age was 34 years. 78% of the patients were men. One-third had multiple injuries, one-half had injuries of the ipsilateral knee and one-half had other lower limb injuries. The femoral neck fractures were most often basilar and the reported rate of avascular necrosis was 3%. The trochanteric fractures were intertrochanteric transverse, and seldom comminuted. The important factors in reducing morbidity were an early diagnosis of all injuries and efficient treatment of the shaft fractures. Locked intramedullary nails yielded results which were superior to combinations of plates or unlocked nails and separate hip screws. Reconstruction nails (cephalomedullary nails) gave results equal to those of customary locked nails and separate hip screws. The rate of healing of the hip fracture was over 99%, the treatment of the shaft fracture being of main importance for the outcome.