股骨颈骨折内固定手术的研究历程与展望

梅炯

doi:10.3969/j.issn.2095-252X.2015.02.002

摘要：Femoral neck fracture is one of the major damages to health and life in the elderly population. But man has had his own understanding of that damage for only 600 years. The following research efforts had their milepost signiifcance in the development of the internal ifxation operation on femoral neck fracture. In 1858, a German surgeon, Von Langenbeck, did the ifrst internal ifxation of femoral neck fracture. But the patient unfortunately died of septicemia. In 1875, Franz K?nig succeeded in the same operation with metal screws on disinfection. In 1883, Nicholass Senn, an American Surgeon, suggested that all femoral neck fractures should be treated with operation based on his animal experiments, but his proposal was not widely accepted. In 1931, Smith-Petersen etc. from the USA ifrst published the results of open reduction and internal ifxation of femoral neck fracture with the use of triifn nail. In 1938, an American doctor, Henderson, publisized his results of the treatment of femoral neck fracture with cannulated screws in Mayo Clinic. In 1941, American Academy of Orthopaedic Surgeons ( AAOS ) advocated the technique of triifn nail, which was pointed out to be unsuitable for the displaced femoral neck fracture by British Medical Research Council in 1976. Asnis cannulated screws appeared in 1980, which is still in use today. Fairly good effects have been achieved in the treatment of femoral neck fracture with internal ifxation, but in some patients it still results in the necrosis of the femoral head. Thus, people are still making different choices between arthroplasty or internal ifxation for the femoral neck fracture, depending largely on the surgeon’s judgment on the degree of the impairment on blood supply to femoral head after the fracture and the influence of the impairment on its healing. The individualized choice of operation method, the maximal retainability of the femoral head blood supply, and the retaining of the residual blood supply from the impairment will be the focus in the future research.