股骨转子间骨折:内固定装置改进、术式变化及其相关争议
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摘要
背景:股骨转子间骨折的治疗方式多样,大体可分为髓外固定系统、髓内固定系统及人工髋关节置换,不同的治疗方法都有着各自的优势及不足,随着研究的深入,相关争议问题亦成为临床研究的热点。目的:综述股骨转子间骨折内固定装置的改进、术式变化及相关争议问题,为进一步的临床研究提供参考。方法:由第一作者以"股骨转子间骨折;髋骨折;骨质疏松;骨折固定术,内;关节成形术,置换,髋;内固定器;假体植入;生物假体;并发症;老年人"为关键词,检索中国知网、万方数据库;以"intertrochanteric fracture;osteoporosis;hip fractures;fracture fixation,internal;Arthroplasty,replacement,hip;bone plates;internal fixators;prosthesis implantation;aged"为关键词,检索PubMed数据库、Web of Science、Springer Link等英文数据库,收集2008年1月至2018年8月发表的相关文献,通过阅读文献题目及摘要进行初步筛选,最终选取56篇文献进行分析。结果与结论:①随着学者们对股骨近端特有的解剖学及生物力学特点的深入研究,股骨转子间骨折分型系统正逐步发展并完善中,以正确评估骨折的严重程度及判断预后;②临床上股骨转子间骨折的手术治疗尚无统一的"金标准",临床上需辨证性的为患者选择个体化的治疗方案;③人工髋关节置换作为骨科手术治疗史上"创世纪性的手术",在老年转子间骨折患者中的应用比例日益增大,但须严格把握手术指征;④股骨转子间骨折的治疗中存在较多的争议性问题,仍需大量多中心、大数据的临床研究来解决;⑤数字化医学的飞速发展,未来将改变股骨转子间骨折的治疗格局。
BACKGROUND: Treatment methods of intertrochanteric fracture are various, which can be divided into extramedullary fixation system,intramedullary fixation system and arthroplasty. Different treatment methods have their own advantages and disadvantages. With the deepening of research, relevant controversial issues have become the hotspot of clinical research.OBJECTIVE: To review the improvement of internal fixation device for intertrochanteric fracture, the changes of operative methods and the related controversial issues, thus providing reference for further clinical research.METHODS: The first author retrieved CNKI, WanFang, PubMed, Web of Science and SpringerLink databases with the keywords of"intertrochanteric fracture, osteoporosis, hip fracture, fracture fixation, internal, arthroplasty, displacement, hip, bone plates, internal fixators,prosthesis implantation, aged" in Chinese and English, respectively. Relevant studies published from January 2008 to August 2018 were collected, and finally 56 eligible studies were included for analysis by reading the title and abstract.RESULTS AND CONCLUSION:(1) With the in-depth study on the characteristics of anatomy and biomechanics of proximal femur, the intertrochanteric fracture classification system is gradually developing and improving to correctly evaluate the severity of fracture and determine the prognosis.(2) There is no unified "gold standard" for the surgical treatment of intertrochanteric fracture. Therefore,individualized treatment plan should be selected for the patient dialectically.(3) As a "turn-of-the-century surgery" in the history of orthopedic surgery, arthroplasty is increasingly applied in elderly patients with intertrochanteric fractures, but the surgical indications should be strictly controlled.(4) There are many controversial issues in the treatment of intertrochanteric fracture, and a large number of multi-center and big data clinical studies are still needed to solve the problem.(5) The rapid development of digital medicine will change the treatment pattern of intertrochanteric fracture.
BACKGROUND: Treatment methods of intertrochanteric fracture are various, which can be divided into extramedullary fixation system,intramedullary fixation system and arthroplasty. Different treatment methods have their own advantages and disadvantages. With the deepening of research, relevant controversial issues have become the hotspot of clinical research.OBJECTIVE: To review the improvement of internal fixation device for intertrochanteric fracture, the changes of operative methods and the related controversial issues, thus providing reference for further clinical research.METHODS: The first author retrieved CNKI, WanFang, PubMed, Web of Science and SpringerLink databases with the keywords of"intertrochanteric fracture, osteoporosis, hip fracture, fracture fixation, internal, arthroplasty, displacement, hip, bone plates, internal fixators,prosthesis implantation, aged" in Chinese and English, respectively. Relevant studies published from January 2008 to August 2018 were collected, and finally 56 eligible studies were included for analysis by reading the title and abstract.RESULTS AND CONCLUSION:(1) With the in-depth study on the characteristics of anatomy and biomechanics of proximal femur, the intertrochanteric fracture classification system is gradually developing and improving to correctly evaluate the severity of fracture and determine the prognosis.(2) There is no unified "gold standard" for the surgical treatment of intertrochanteric fracture. Therefore,individualized treatment plan should be selected for the patient dialectically.(3) As a "turn-of-the-century surgery" in the history of orthopedic surgery, arthroplasty is increasingly applied in elderly patients with intertrochanteric fractures, but the surgical indications should be strictly controlled.(4) There are many controversial issues in the treatment of intertrochanteric fracture, and a large number of multi-center and big data clinical studies are still needed to solve the problem.(5) The rapid development of digital medicine will change the treatment pattern of intertrochanteric fracture.
引文
[1]Ha YC,Park YG,Nam KW,et al.Trend in Hip Fracture Incidence and Mortality in Korea:A Prospective Cohort Study from 2002 to 2011.J Korean Med Sci.2015;30(4):483-488.
[2]Dash SK,Panigrahi R,Palo N,et al.Fragility Hip Fractures in Elderly Patients in Bhubaneswar,India(2012-2014):AProspective Multicenter Study of 1031 Elderly Patients.Geriatr Orthop Surg Rehabil.2015;6(1):11-15.
[3]Sambandam SN,Chandrasekharan J,Mounasamy V,et al.Intertrochanteric fractures:a review of fixation methods.Eur JOrthop Surg Traumatol.2016;26(4):339-353.
[4]Lewis PM,Waddell JP.When is the ideal time to operate on a patient with a fracture of the hip?:a review of the available literature.Bone Joint J.2016;98-B(12):1573-1581.
[5]Chehade MJ,Carbone T,Awwad D,et al.Influence of Fracture Stability on Early Patient Mortality and Reoperation After Pertrochanteric and Intertrochanteric Hip Fractures.J Orthop Trauma.2015;29(12):538-543.
[6]Ong T,Anand V,Tan W,et al.Patient characteristics and outcomes of a hip fracture and concomitant fracture compared with hip fracture alone:results from a United Kingdom teaching hospital.Arch Orthop Trauma Surg.2016;136(4)463-467.
[7]Shin YS,Chae JE,Kang TW,et al.Prospective randomized study comparing two cephalomedullary nails for elderly intertrochanteric fractures:Zimmer natural nail versus proximal femoral nail antirotation II.Injury.2017;48(7):1550-1557.
[8]中华医学会骨科学分会骨质疏松学组.骨质疏松性骨折诊疗指南[J].中华骨科杂志,2017,37(1):1-10.
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[10]Jensen JS,Michaelsen M.Trochanteric femoral fractures treated with Mc Laughlin osteosynthesis.Acta Orthop Scand.1975;46(5):795-803.
[11]Müller MME,Koch MP,Nazarian MS.The Comprehensive Classification of Fractures of Long Bones.Springer Berlin Heidelberg,1991.
[12]Babhulkar S.Unstable trochanteric fractures:Issues and avoiding pitfalls.Injury.2017;48(4):803-818.
[13]M?kinen TJ,Gunton M,Fichman SG,et al.Arthroplasty for Pertrochanteric Hip Fractures.Orthop Clin North Am.2015;46(4):433-444.
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[16]Kazemian GH,Manafi AR,Najafi F,et al.Treatment of intertrochanteric fractures in elderly highrisk patients:dynamic hip screw vs.external fixation.Injury.2014;45(3):568-572.
[17]Sharma G,Singh R,Gn KK,et al.Which AO/OTA 31-A2pertrochanteric fractures can be treated with a dynamic hip screw without developing a lateral wall fracture?A CT-based study.Int Orthop.2016;40(5):1009-1017.
[18]Gotfried Y,Cohen B,Rotem A.Biomechanical evaluation of the percutaneous compression plating system for hip fractures.JOrthop Trauma.2002;16(9):644-650.
[19]Kempegowda H,Richard R,Borade A,et al.The Role of Radiographs and Office Visits in the Follow-Up of Healed Intertrochanteric Hip Fractures:An Economic Analysis.JOrthop Trauma.2016;30(12):687-690.
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[22]Gunadham U,Jampa J,Suntornsup S,et al.The outcome in early cases of treatment of subtrochanteric fractures with proximal femur locking compression plate.Malays Orthop J.2014;8(2):22-28.
[23]Zhang CQ,Sun Y,Jin DX,et al.Reverse LISS plating for intertrochanteric hip fractures in elderly patients.BMCMusculoskelet Disord.2010;11:166.
[24]Norris R,Bhattacharjee D,Parker MJ.Occurrence of secondary fracture around intramedullary nails used for trochanteric hip fractures:a systematic review of 13,568patients.Injury.2012;43(6):706-711.
[25]Haq RU,Manhas V,Pankaj A,et al.Proximal femoral nails compared with reverse distal femoral locking plates in intertrochanteric fractures with a compromised lateral wall;a randomised controlled trial.Int Orthop.2014;38(7):1443-1449.
[26]Werner-Tutschku W,Lajtai G,Schmiedhuber G,et al.Intra-and perioperative complications in the stabilization of per-and subtrochanteric femoral fractures by means of PFN.Unfallchirurg.2002;105(10):881-885.
[27]Lenich A,Vester H,Nerlich M,et al.Clinical comparison of the second and third generation of intramedullary devices for trochanteric fractures of the hip--Blade vs screw.Injury.2010;41(12):1292-1296.
[28]Ma KL,Wang X,Luan FJ,et al.Proximal femoral nails antirotation,Gamma nails,and dynamic hip screws for fixation of intertrochanteric fractures of femur:A meta-analysis.Orthop Traumatol Surg Res.2014;100(8):859-66.
[29]Makki D,Matar HE,Jacob N,et al.Comparison of the reconstruction trochanteric antigrade nail(TAN)with the proximal femoral nail antirotation(PFNA)in the management of reverse oblique intertrochanteric hip fractures.Injury.2015;46(12):2389-2393.
[30]Tyagi V,Yang JH,Oh KJ.A computed tomography-based analysis of proximal femoral geometry for lateral impingement with two types of proximal femoral nail anterotation in subtrochanteric fractures.Injury.2010;41(8):857-861.
[31]Li J,Cheng L,Jing J.The Asia proximal femoral nail antirotation versus the standard proximal femoral antirotation nail for unstable intertrochanteric fractures in elderly Chinese patients.Orthop Traumatol Surg Res.2015;101(2):143-146.
[32]Zehir S,?ahin E,Zehir R.Comparison of clinical outcomes with three different intramedullary nailing devices in the treatment of unstable trochanteric fractures.Ulus Travma Acil Cerrahi Derg.2015;21(6):469-476.
[33]Yu W,Zhang X,Zhu X,et al.A retrospective analysis of the Inter Tan nail and proximal femoral nail anti-rotation-Asia in the treatment of unstable intertrochanteric femur fractures in the elderly.J Orthop Surg Res.2016;11:10.
[34]Huang Y,Zhang C,Luo Y.A comparative biomechanical study of proximal femoral nail(Inter TAN)and proximal femoral nail antirotation for intertrochanteric fractures.Int Orthop.2013;37(12):2465-2473.
[35]Galli M,Ciriello V,Bocchino L,et al.Clinical and functional outcomes of internal fixation with intertrochanteric antegrade nail in older patients with proximal extracapsular femoral fractures.Eur J Trauma Emerg Surg.2014;40(4):495-500.
[36]Steinberg EL,Sternheim A,Blachar A.Femoral head density on CT scans of patients following hip fracture fixation by expandable proximal peg or dynamic screw.Injury.2010;41(6):647-651.
[37]Michael D,Yaniv W,Tal FR,et al.Expandable proximal femoral nail versus gamma proximal femoral nail for the treatment of AO/OTA 31A1-3 fractures.Injury.2016;47(2):419-423.
[38]Gao F,Zhang CQ,Chai YM,et al.Expandable Proximal Femoral Nails(EPFNs)in Elderly Patients.J Invest Surg.2015;28(3):140-144.
[39]Yee DK,Fang C,Lau TW,et al.Seasonal Variation in Hip Fracture Mortality.Geriatr Orthop Surg Rehabil.2017;8(1):49-53.
[40]Palm H,Lysén C,Krasheninnikoff M,et al.Intramedullary nailing appears to be superior in pertrochanteric hip fractures with a detached greater trochanter:311 consecutive patients followed for 1 year.Acta Orthop.2011;82(2):166-170.
[41]Marmor M,Elliott IS,Marshall ST,et al.Biomechanical comparison of long,short,and extended-short nail construct for femoral intertrochanteric fractures.Injury.2015;46(6):963-969.
[42]Niu E,Yang A,Harris AH,et al.Which Fixation Device is Preferred for Surgical Treatment of Intertrochanteric Hip Fractures in the United States?A Survey of Orthopaedic Surgeons.Clin Orthop Relat Res.2015;473(11):3647-3655.
[43]胡广.创伤骨科诊治失误对策[M].北京:人民卫生出版社,2002.
[44]Xie J,Hu Q,Huang Q,et al.Comparison of intravenous versus topical tranexamic acid in primary total hip and knee arthroplasty:An updated meta-analysis.Thromb Res.2017;153:28-36.
[45]Jameson SS,Lees D,James P,et al.Lower rates of dislocation with increased femoral head size after primary total hip replacement:a five-year analysis of NHS patients in England.J Bone Joint Surg Br.2011;93(7):876-880.
[46]Yu L,Wang Y,Chen J.Total hip arthroplasty versus hemiarthroplasty for displaced femoral neck fractures:meta-analysis of randomized trials.Clin Orthop Relat Res.2012;470(8):2235-2243.
[47]Gjertsen JE,Fenstad AM,Leonardsson O,et al.Hemiarthroplasties after hip fractures in Norway and Sweden:a collaboration between the Norwegian and Swedish national registries.Hip Int.2014;24(3):223-230.
[48]Morris K,Davies H,Wronka K.Implant-related complications following hip hemiarthroplasty:a comparison of modern cemented and uncemented prostheses.Eur J Orthop Surg Traumatol.2015;25(7):1161-1164.
[49]Griffiths R,Parker M.Bone cement implantation syndrome and proximal femoral fracture.Br J Anaesth.2015;114(1):6-7.
[50]Grosso MG,Danoff JR,Padgett DE,et al.The Cemented Unipolar Prosthesis for the Management of Displaced Femoral Neck Fractures in the Dependent Osteopenic Elderly.J Arthroplasty.2016;31(5):1040-1046.
[51]Sk?ldenberg OG,Sj??H,Kelly-Pettersson P,et al.Good stability but high periprosthetic bone mineral loss and late-occurring periprosthetic fractures with use of uncemented tapered femoral stems in patients with a femoral neck fracture.Acta Orthop.2014;85(4):396-402.
[52]邱贵兴.中国骨科大手术静脉血栓栓塞症预防指南[J].中华骨科杂志,2016,36(2):65-71.
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[54]Xie J,Ma J,Yue C,et al.Combined use of intravenous and topical tranexamic acid following cementless total hip arthroplasty:a randomised clinical trial.Hip Int.2016;26(1):36-42.
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[2]Dash SK,Panigrahi R,Palo N,et al.Fragility Hip Fractures in Elderly Patients in Bhubaneswar,India(2012-2014):AProspective Multicenter Study of 1031 Elderly Patients.Geriatr Orthop Surg Rehabil.2015;6(1):11-15.
[3]Sambandam SN,Chandrasekharan J,Mounasamy V,et al.Intertrochanteric fractures:a review of fixation methods.Eur JOrthop Surg Traumatol.2016;26(4):339-353.
[4]Lewis PM,Waddell JP.When is the ideal time to operate on a patient with a fracture of the hip?:a review of the available literature.Bone Joint J.2016;98-B(12):1573-1581.
[5]Chehade MJ,Carbone T,Awwad D,et al.Influence of Fracture Stability on Early Patient Mortality and Reoperation After Pertrochanteric and Intertrochanteric Hip Fractures.J Orthop Trauma.2015;29(12):538-543.
[6]Ong T,Anand V,Tan W,et al.Patient characteristics and outcomes of a hip fracture and concomitant fracture compared with hip fracture alone:results from a United Kingdom teaching hospital.Arch Orthop Trauma Surg.2016;136(4)463-467.
[7]Shin YS,Chae JE,Kang TW,et al.Prospective randomized study comparing two cephalomedullary nails for elderly intertrochanteric fractures:Zimmer natural nail versus proximal femoral nail antirotation II.Injury.2017;48(7):1550-1557.
[8]中华医学会骨科学分会骨质疏松学组.骨质疏松性骨折诊疗指南[J].中华骨科杂志,2017,37(1):1-10.
[9]Evans EM.The treatment of trochanteric fractures of the femur.J Bone Joint Surg Br.1949;31B(2):190-203.
[10]Jensen JS,Michaelsen M.Trochanteric femoral fractures treated with Mc Laughlin osteosynthesis.Acta Orthop Scand.1975;46(5):795-803.
[11]Müller MME,Koch MP,Nazarian MS.The Comprehensive Classification of Fractures of Long Bones.Springer Berlin Heidelberg,1991.
[12]Babhulkar S.Unstable trochanteric fractures:Issues and avoiding pitfalls.Injury.2017;48(4):803-818.
[13]M?kinen TJ,Gunton M,Fichman SG,et al.Arthroplasty for Pertrochanteric Hip Fractures.Orthop Clin North Am.2015;46(4):433-444.
[14]Kokoroghiannis C,Aktselis I,Deligeorgis A,et al.Evolving concepts of stability and intramedullary fixation of intertrochanteric fractures-a review.Injury.2012;43(6):686-693.
[15]Aktselis I,Kokoroghiannis C,Fragkomichalos E,et al.Prospective randomised controlled trial of an intramedullary nail versus a sliding hip screw for intertrochanteric fractures of the femur.Int Orthop.2014;38(1):155-161.
[16]Kazemian GH,Manafi AR,Najafi F,et al.Treatment of intertrochanteric fractures in elderly highrisk patients:dynamic hip screw vs.external fixation.Injury.2014;45(3):568-572.
[17]Sharma G,Singh R,Gn KK,et al.Which AO/OTA 31-A2pertrochanteric fractures can be treated with a dynamic hip screw without developing a lateral wall fracture?A CT-based study.Int Orthop.2016;40(5):1009-1017.
[18]Gotfried Y,Cohen B,Rotem A.Biomechanical evaluation of the percutaneous compression plating system for hip fractures.JOrthop Trauma.2002;16(9):644-650.
[19]Kempegowda H,Richard R,Borade A,et al.The Role of Radiographs and Office Visits in the Follow-Up of Healed Intertrochanteric Hip Fractures:An Economic Analysis.JOrthop Trauma.2016;30(12):687-690.
[20]Dhamangaonkar AC,Joshi D,Goregaonkar AB,et al.Proximal femoral locking plate versus dynamic hip screw for unstable intertrochanteric femoral fractures.J Orthop Surg(Hong Kong).2013;21(3):317-322.
[21]Azboy I,Demirta?A,Gem M,et al.A comparison of proximal femoral locking plate versus 95-degree angled blade plate in the treatment of reverse intertrochanteric fractures.Eklem Hastalik Cerrahisi.2014;25(1):15-20.
[22]Gunadham U,Jampa J,Suntornsup S,et al.The outcome in early cases of treatment of subtrochanteric fractures with proximal femur locking compression plate.Malays Orthop J.2014;8(2):22-28.
[23]Zhang CQ,Sun Y,Jin DX,et al.Reverse LISS plating for intertrochanteric hip fractures in elderly patients.BMCMusculoskelet Disord.2010;11:166.
[24]Norris R,Bhattacharjee D,Parker MJ.Occurrence of secondary fracture around intramedullary nails used for trochanteric hip fractures:a systematic review of 13,568patients.Injury.2012;43(6):706-711.
[25]Haq RU,Manhas V,Pankaj A,et al.Proximal femoral nails compared with reverse distal femoral locking plates in intertrochanteric fractures with a compromised lateral wall;a randomised controlled trial.Int Orthop.2014;38(7):1443-1449.
[26]Werner-Tutschku W,Lajtai G,Schmiedhuber G,et al.Intra-and perioperative complications in the stabilization of per-and subtrochanteric femoral fractures by means of PFN.Unfallchirurg.2002;105(10):881-885.
[27]Lenich A,Vester H,Nerlich M,et al.Clinical comparison of the second and third generation of intramedullary devices for trochanteric fractures of the hip--Blade vs screw.Injury.2010;41(12):1292-1296.
[28]Ma KL,Wang X,Luan FJ,et al.Proximal femoral nails antirotation,Gamma nails,and dynamic hip screws for fixation of intertrochanteric fractures of femur:A meta-analysis.Orthop Traumatol Surg Res.2014;100(8):859-66.
[29]Makki D,Matar HE,Jacob N,et al.Comparison of the reconstruction trochanteric antigrade nail(TAN)with the proximal femoral nail antirotation(PFNA)in the management of reverse oblique intertrochanteric hip fractures.Injury.2015;46(12):2389-2393.
[30]Tyagi V,Yang JH,Oh KJ.A computed tomography-based analysis of proximal femoral geometry for lateral impingement with two types of proximal femoral nail anterotation in subtrochanteric fractures.Injury.2010;41(8):857-861.
[31]Li J,Cheng L,Jing J.The Asia proximal femoral nail antirotation versus the standard proximal femoral antirotation nail for unstable intertrochanteric fractures in elderly Chinese patients.Orthop Traumatol Surg Res.2015;101(2):143-146.
[32]Zehir S,?ahin E,Zehir R.Comparison of clinical outcomes with three different intramedullary nailing devices in the treatment of unstable trochanteric fractures.Ulus Travma Acil Cerrahi Derg.2015;21(6):469-476.
[33]Yu W,Zhang X,Zhu X,et al.A retrospective analysis of the Inter Tan nail and proximal femoral nail anti-rotation-Asia in the treatment of unstable intertrochanteric femur fractures in the elderly.J Orthop Surg Res.2016;11:10.
[34]Huang Y,Zhang C,Luo Y.A comparative biomechanical study of proximal femoral nail(Inter TAN)and proximal femoral nail antirotation for intertrochanteric fractures.Int Orthop.2013;37(12):2465-2473.
[35]Galli M,Ciriello V,Bocchino L,et al.Clinical and functional outcomes of internal fixation with intertrochanteric antegrade nail in older patients with proximal extracapsular femoral fractures.Eur J Trauma Emerg Surg.2014;40(4):495-500.
[36]Steinberg EL,Sternheim A,Blachar A.Femoral head density on CT scans of patients following hip fracture fixation by expandable proximal peg or dynamic screw.Injury.2010;41(6):647-651.
[37]Michael D,Yaniv W,Tal FR,et al.Expandable proximal femoral nail versus gamma proximal femoral nail for the treatment of AO/OTA 31A1-3 fractures.Injury.2016;47(2):419-423.
[38]Gao F,Zhang CQ,Chai YM,et al.Expandable Proximal Femoral Nails(EPFNs)in Elderly Patients.J Invest Surg.2015;28(3):140-144.
[39]Yee DK,Fang C,Lau TW,et al.Seasonal Variation in Hip Fracture Mortality.Geriatr Orthop Surg Rehabil.2017;8(1):49-53.
[40]Palm H,Lysén C,Krasheninnikoff M,et al.Intramedullary nailing appears to be superior in pertrochanteric hip fractures with a detached greater trochanter:311 consecutive patients followed for 1 year.Acta Orthop.2011;82(2):166-170.
[41]Marmor M,Elliott IS,Marshall ST,et al.Biomechanical comparison of long,short,and extended-short nail construct for femoral intertrochanteric fractures.Injury.2015;46(6):963-969.
[42]Niu E,Yang A,Harris AH,et al.Which Fixation Device is Preferred for Surgical Treatment of Intertrochanteric Hip Fractures in the United States?A Survey of Orthopaedic Surgeons.Clin Orthop Relat Res.2015;473(11):3647-3655.
[43]胡广.创伤骨科诊治失误对策[M].北京:人民卫生出版社,2002.
[44]Xie J,Hu Q,Huang Q,et al.Comparison of intravenous versus topical tranexamic acid in primary total hip and knee arthroplasty:An updated meta-analysis.Thromb Res.2017;153:28-36.
[45]Jameson SS,Lees D,James P,et al.Lower rates of dislocation with increased femoral head size after primary total hip replacement:a five-year analysis of NHS patients in England.J Bone Joint Surg Br.2011;93(7):876-880.
[46]Yu L,Wang Y,Chen J.Total hip arthroplasty versus hemiarthroplasty for displaced femoral neck fractures:meta-analysis of randomized trials.Clin Orthop Relat Res.2012;470(8):2235-2243.
[47]Gjertsen JE,Fenstad AM,Leonardsson O,et al.Hemiarthroplasties after hip fractures in Norway and Sweden:a collaboration between the Norwegian and Swedish national registries.Hip Int.2014;24(3):223-230.
[48]Morris K,Davies H,Wronka K.Implant-related complications following hip hemiarthroplasty:a comparison of modern cemented and uncemented prostheses.Eur J Orthop Surg Traumatol.2015;25(7):1161-1164.
[49]Griffiths R,Parker M.Bone cement implantation syndrome and proximal femoral fracture.Br J Anaesth.2015;114(1):6-7.
[50]Grosso MG,Danoff JR,Padgett DE,et al.The Cemented Unipolar Prosthesis for the Management of Displaced Femoral Neck Fractures in the Dependent Osteopenic Elderly.J Arthroplasty.2016;31(5):1040-1046.
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