Total hip replacement for hip fracture: Surgical techniques and concepts

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• 作者：Ross Coomber^a ; ^{rosscoomber@hotmail.com" class="auth_mail" title="E-mail the corresponding author} (Orthopaedic registrar) ; Matthew Porteous^b ; ^{matthew.porteous@wsh.nhs.uk" class="auth_mail" title="E-mail the corresponding author} (Consultant orthopaedic surgeon) ; Matthew J.W. Hubble^c ; ^{matthew.hubble@nhs.net" class="auth_mail" title="E-mail the corresponding author} (Consultant orthopaedic surgeon) ; Martyn J. Parker^a ; ^{Martyn.Parker@pbh-tr.nhs.uk" class="auth_mail" title="E-mail the corresponding author} (Consultant orthopaedic surgeon)
• 关键词：Hip fracture ; Total hip replacement ; Instructional review
• 刊名：Injury
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：47
• 期：10
• 页码：2060-2064
• 全文大小：481 K

文摘

When treating a hip fracture with a total hip replacement (THR) the surgical technique may differ in a number of aspects in comparison to elective arthroplasty. The hip fracture patient is more likely to have poor bone stock secondary to osteoporosis, be older, have a greater number of co-morbidities, and have had limited peri-operative work-up. These factors lead to a higher risk of complications, morbidity and perioperative mortality.

Consideration should be made to performing the THR in a laminar flow theatre, by a surgeon experienced in total hip arthroplasty, using an anterolateral approach, cementing the implant in place, using a large head size and with repair of the joint capsule. Combined Ortho-geriatric care is recommended with similar post-operative rehabilitation to elective THR patients but with less expectation of short length of stay and consideration for fracture prevention measures.