股骨颈骨折全英文教学版陈芒芒ppt课件.ppt

compressive internal fixation Bone grafting＋IF ①free bone graft ②pedicle bone graft： Sartorius musculoskeletal flapquadratus femoris muscle pedicle bone graft Hip joint replacement Subcapital in elderly people、old fracture、nonunion/AVN(avascular necrosis of femoral head) Total hip arthroplasty Hemiarthroplasty Unipolar Bipolar Historically,higher dislocation rate More invasive Hemiarthroplasty Total hip arthroplasty Expectation 20-30% patient will die within 1 year of surgery 3% in-hospital mortality rate Up to 30% require revision surgery Expectation 这里的原话，我觉得翻译下好。 As the prolonged lifespan The rate of fracture Problem:AVN,nonunion,BUT chance. Q1：??? Thanks Femoral Neck Fractures---a changing paradigm Department of Orthopaedics---Mangmang Chen Definition 1 one of the most commonly treated orthopaedic injuries,3.58% 2 increasing number of femoral neck fractures. Longer lifespan of patients Increased activity of patients Osteoporosis 3(这里可以放一些图片) Demographics: Most 75y Over 1 million femoral neck fractures were treated in the 65 year old population in the US Between 1991-2008. (有一张图片最好，地图分布图) Hip Fractures:Demographics Very heterogeneous patient population Can ranger from independent mobile,healthy elderly patients Vary degress of dementia(1分38的时候看不懂) 110°~140°，average 127° 。 140 ° coxa valgus 110 ° coxa vara Anatomy Collodiaphysial angle Axis… Anatomy Collodiaphysial angle Axis… Elderly people：indirect violence——low energy damage Young adults： indirect violence——high energy damage nonunion10％－20％（ shear force greater ），AVN20％－40％（Blood supply） femoral neck?anteversion The axis of the femoral neck and femoral coronary forming Angle,12°~15° Anatomy ① Small artery ：Femoral head round ligament ，1/20 ②shaft of the femur;nutrient artery ③ the?artery?ring?on the?fundus?of?neck?of?femur ： medial femoral circumflex artery; lateral femoral circumflex artery ;The main source ， 2/3 － 4/5 Anatomy Blood supply Blood supply Anatomy medial femoral c