股骨转子间骨折累及内侧壁损伤患者治疗策略的研究进展

doi:10.13481/j.1671-587X.20260132

摘要/Abstract

摘要：

股骨转子间骨折（ITFF）是指发生于大转子与小转子之间的骨折，属于髋关节囊外骨折，其中累及内侧壁损伤的患者类型在临床中较为多见。对于累及内侧壁损伤的ITFF的治疗方法主要以手术为主。手术方法主要包括髓外固定和髓内固定，但对于采取何种内固定治疗方式目前尚无统一的观点，尤其在涉及内侧壁不稳定的复杂病例中，选择髓外固定或是髓内固定仍存争议。最佳治疗方式需根据内侧壁的稳定情况以及患者的基础条件进行个体化决策，如骨质量、并发症和年龄等因素。然而，对于不稳定型内侧壁损伤的患者，应优先恢复内侧壁的骨性支撑和皮质的连续性，以重建力学稳定性并降低内固定失败风险。现将对股骨转子间的解剖结构、ITFF的损伤机制、骨折分型、生物力学研究和累及内侧壁损伤的ITFF内固定治疗方法进行综述，系统比较不同固定策略的优劣，为治疗累及内侧壁损伤的ITFF患者提供参考，以期改善患者预后并促进临床规范化治疗。

关键词: 股骨转子间骨折, 内侧壁, 解剖结构, 骨折分型, 内固定

Abstract:

Intertrochanteric femoral fracture （ITFF） refers to a fracture occurring between the greater trochanter and the lesser trochanter， which is an extracapsular fracture of the hip joint. Among these， the type involving medial wall injury is relatively common in clinical practice. The treatment for ITFF involving medial wall injury is primarily surgical. Surgical methods mainly include extramedullary fixation and intramedullary fixation. However， there is currently no unified consensus on which internal fixation method to adopt， especially for complex cases involving medial wall instability， where the choice between extramedullary and intramedullary fixation remains controversial. The optimal treatment approach requires individualized decision-making based on the stability of the medial wall and the patient’s baseline conditions， such as bone quality， complications， and age. Nevertheless， for patients with unstable medial wall injury， priority should be given to restoring the bony support of the medial wall and cortical continuity to reconstruct mechanical stability and reduce the risk of internal fixation failure. This article reviews the anatomical structure of the intertrochanteric region， the injury mechanism of ITFF， fracture classification， biomechanical research， and internal fixation treatment methods for ITFF involving medial wall injury. It systematically compares the advantages and disadvantages of different fixation strategies， aiming to provide the reference for the treatment of ITFF patients with medial wall injury， with the goal of improving patient prognosis and promoting standardized clinical management.

Key words: Intertrochanteric femoral fracture, Medial wall, Anatomical structure, Fracture classification, Internal fixation

中图分类号:

R683.42

苗锦虎,戴琎,陈志豪,邵国喜. 股骨转子间骨折累及内侧壁损伤患者治疗策略的研究进展[J]. 吉林大学学报(医学版), 2026, 52(1): 290-298.

Jinhu MIAO,Jin DAI,Zhihao CHEN,Guoxi SHAO. Research progress in treatment strategies for patients with intertrochanteric femoral fractures involving medial wall damage[J]. Journal of Jilin University(Medicine Edition), 2026, 52(1): 290-298.

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