CAJ | 학술논문

背景:股骨近端骨折好发于老年人群,治疗时选择适宜的内固定植入物是保证生物相容性以及效果的关键.目的:分析股骨近端骨折内固定金属植入物的选择以及生物相容性.方法:由第一作者于2012年12月应用计算机检索国内外数据库相关文章,中文检索词为“股骨近端骨折,动力髋螺钉,微创固定系统,经皮加压钢板,Gamma 钉,髓内钉”,英文检索词为“proximal femoral fracture,dynamic hip screw,less invasive stabilization system,percutaneous compression plate, Gamma nail”,并限定文章语言种类为中文和英文.共检索到相关文献142篇,符合纳入标准并用于分析的文献17篇.结果与结论:①股骨近端骨折的治疗方法有几种,包括保守治疗、金属植入物内固定治疗、外固定支架固定、锁定钢板以及人工假体置换治疗等.目前国内外的治疗观点已摒弃牵引等保守治疗方法,尽量行金属植入物内固定.②临床金属植入物内固定的选择主要分为髓外固定装置和髓内固定装置,髓外固定装置包括动力髋螺钉、经皮加压钢板、股骨远端倒置微创固定系统,髓内固定装置包括股骨近端髓内钉、Gamma 钉、重建钉等.③每种治疗方法和植入物内固定装置都有其各自的优点及局限,临床治疗中要根据患者病情和治疗需要提出个性化的治疗方案,选择适宜的方法.
배경:고골근단골절호발우노년인군,치료시선택괄의적내고정식입물시보증생물상용성이급효과적관건.목적:분석고골근단골절내고정금속식입물적선택이급생물상용성.방법:유제일작자우2012년12월응용계산궤검색국내외수거고상관문장,중문검색사위“고골근단골절,동력관라정,미창고정계통,경피가압강판,Gamma 정,수내정”,영문검색사위“proximal femoral fracture,dynamic hip screw,less invasive stabilization system,percutaneous compression plate, Gamma nail”,병한정문장어언충류위중문화영문.공검색도상관문헌142편,부합납입표준병용우분석적문헌17편.결과여결론:①고골근단골절적치료방법유궤충,포괄보수치료、금속식입물내고정치료、외고정지가고정、쇄정강판이급인공가체치환치료등.목전국내외적치료관점이병기견인등보수치료방법,진량행금속식입물내고정.②림상금속식입물내고정적선택주요분위수외고정장치화수내고정장치,수외고정장치포괄동력관라정、경피가압강판、고골원단도치미창고정계통,수내고정장치포괄고골근단수내정、Gamma 정、중건정등.③매충치료방법화식입물내고정장치도유기각자적우점급국한,림상치료중요근거환자병정화치료수요제출개성화적치료방안,선택괄의적방법.
BACKGROUND: Proximal femoral fracture often occurs in elderly population, and selecting the appropriate fixation implants is the key to guarantee the biocompatibility and treatment effect. OBJECTIVE: To analyze the selection and the biocompatibility of the metal implants for internal fixation for the treatment of proximal femoral fracture. METHODS: The relative databases at home and abroad were searched by the first author for the relative articles in December 2012. The Chinese key words were “proximal femoral fracture, dynamic hip screw, less invasive stabilization system, percutaneous compression plate, Gamma nail, intramedul ary nail”, and the English key words were “proximal femoral fracture, dynamic hip screw, less invasive stabilization system, percutaneous compression plate, Gamma nail”. The literatures of the articles were Chinese and English. A total of 142 articles were screened out, and 17 articles were included for the final analysis according to the inclusion criteria. RESULTS AND CONCLUSION: The methods for the treatment of proximal femoral fracture included conservative treatment, metal implants internal fixation, external fixation, locking plate and prosthesis replacement therapy. At present, the domestic and international treatment points have abandoned the conservative treatments such as traction, and try best to perform the metal implants internal fixation. The clinical metal implants internal fixation can be divided into extramedul ary fixation device and intramedul ary fixation device, and the extramedul ary fixation device included dynamic hip screw, inverted distal femoral less invasive stabilization system and percutaneous compression plate, while the intramedul ary fixation device included the proximal femoral intramedul ary nail, Gamma nail and reconstruction nail. Each treatment method and internal fixation device has their own advantages and limitations. We should propose a personalized treatment program and select the appropriate method according to the patient’s condition and treatment requirement during the clinical treatment.