股骨颈骨折全英文论文一篇.docxVIP

Fractured Neck of Femur—Internal Fixation Versus ArthroplastyErnst Sendtner, Dr. med.,*1 Tobias Renkawitz, Dr. med.,1 Peter Kramny, Dr. med.,1 Michael Wenzl, PD Dr. med.,2 and Joachim Grifka, Prof. Dr. med.11Asklepios Klinikum Bad Abbach, Orthop?dische Klinik für die Universit?t Regensburg2Klinikum Ingolstadt, Chirurgische Klinik II für Unfall-, Wiederherstellungs-, Hand- und Plastische Chirurgie*Asklepios Klinikum Bad Abbach, Orthop?dische Klinik für die Universit?t Regensburg, Kaiser-Karl V.-Allee 3, 93077 Bad Abbach, Germany, Email: ernst.sendtner@web.deReceived April 2, 2008; Accepted August 20, 2009.?Other Sections▼AbstractMethodsBiomechanicsClinical pictureDiagnostic evaluationTherapeutic indicationsOsteosynthesisEndoprosthesisAftercareMortality and morbidityToday’s healthcare situationReferencesAbstractBackgroundSurgery is the treatment of choice for fractured neck of femur. For middle-aged patients (aged ca. 40 to 65), there is considerable debate over the indications for arthroplasty or internal fixation. The choice of surgical technique varies widely from one region to another. In this article, we discuss the main criteria that should be used in making this decision.MethodsWe selectively reviewed the literature on the diagnosis and treatment of fractured neck of femur, including the current guideline of the German Society for Trauma Surgery (Deutsche Gesellschaft für Unfallchirurgie, DGU) and recent findings from the field of health services research.ResultsThe treatment of middle-aged patients with dislocated fractures should be based on rational decision-making. The patient’s level of activity before the accident should be judged in terms of his or her previous mobility, independence in daily activities, and mental status. Internal fixation is recommended if the fracture can be adequately repositioned, the bone is of good quality, and there is no evidence of osteoarthritis. Fractures that are more than 24 hours old should be treated with total hip arthro