Advances in anteromedial cortical support reduction of trochanteric hip fractures

doi:10.3877/cma.j.issn.2096-0263.2023.03.008

Abstract

Abstract:

The trochanteric hip fracture is one of the most serious public health issues. Surgical intervention achieves early mobilization and prevents secondary complications. In recent years, the positive anteromedial cortical support, one non-anatomical fracture reduction technique, acquired wide recognition but with new controversial issues: the lack of experimental studies; the comparison between positive and neutral cortical support; the comparison between anterior and medial cortical support; the difference between neutral cortical support and anatomical reduction; and the comparison between Chang and Baumgaertner reduction quality criteria. This review provides an overview of related reports of clinical study, finite element analysis as well as biomechanical testing, and summarizes the research progress and debate in this field.

Key words: Trochanteric hip fractures, Anteromedial cortical support, Fracture reduction

Wei Mao, Shimin Zhang, Yingqi Zhang, Sunjun Hu, Shouchao Du. Advances in anteromedial cortical support reduction of trochanteric hip fractures[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2023, 09(03): 182-187.

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References 47

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研究	正性支撑vs.中性支撑（稳定性）	前侧支撑vs.内侧支撑（重要性）	中性支撑vs.解剖复位（定义）	缺点
基础研究
有限元分析	正性>中性	无明确结论	中性＝解剖	样本量小，模型设计不符合实际
生物力学测试	存在争议	存在争议	中性＝解剖	缺乏尸体标本研究
临床研究
回顾性研究	前侧：正性＝中性内侧：尽量正性	存在争议	中性≠解剖	多为小样本量、单中心研究
前瞻性研究	无相关研究	无相关研究	无相关研究	无相关研究

研究	正性支撑vs.中性支撑（稳定性）	前侧支撑vs.内侧支撑（重要性）	中性支撑vs.解剖复位（定义）	缺点
基础研究
有限元分析	正性>中性	无明确结论	中性＝解剖	样本量小，模型设计不符合实际
生物力学测试	存在争议	存在争议	中性＝解剖	缺乏尸体标本研究
临床研究
回顾性研究	前侧：正性＝中性内侧：尽量正性	存在争议	中性≠解剖	多为小样本量、单中心研究
前瞻性研究	无相关研究	无相关研究	无相关研究	无相关研究

项目	得分
I.对线
a.正位片：正常或轻度外翻的颈干角(外翻不超过10°)	1
b.侧位片：小于20°的成角	1
Ⅱ.对位
a.正位片：中性或正性内侧皮质支撑	1
b.侧位片：平齐的前侧皮质接触（位移小于皮质厚度的一半）	1
复位质量
优	4
中	3
差	≤2

项目	得分
I.对线
a.正位片：正常或轻度外翻的颈干角(外翻不超过10°)	1
b.侧位片：小于20°的成角	1
Ⅱ.对位
a.正位片：中性或正性内侧皮质支撑	1
b.侧位片：平齐的前侧皮质接触（位移小于皮质厚度的一半）	1
复位质量
优	4
中	3
差	≤2

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