 机器翻译字幕，仅供参考： intertrochanteric fractures it occurs in the region between the 转子间骨折 它发生在 creator and the lesser trochanter of the proximal femur 股骨近端的创建者和小转子之间的区域 it is approximately 50% of all proximal femur fractures the neck is about 40% 它约占所有股骨近端骨折的 50% 颈部约为 40% are important trabecular pattern at the proximal femur and it appears according 是股骨近端的重要骨小梁模式， to the wolf law response of the bone to stress 根据wolf定律出现 骨骼对应力的反应 there is a primary inside curricula and there is a primary compression 有一个主要的内部课程，有一个主要的压缩， particularly also our secondary tensile and compression probably in between them 特别是我们的次要拉伸和压缩，可能在它们 there is the ward triangle which is a weak area 之间有一个ward三角，这是一个薄弱的区域， side forces can create micro fractures or stress fractures at this wheel your 侧向力可以在这个位置产生微骨折或应力性骨折 转动你的 neck in response to the repeated load are some important points related to 股骨颈以应对重复的负荷是与股骨近端骨折有关的一些重要点， fractures of the proximal femur especially in the elderly 尤其是在老年人中 one is the DVT which can occur in about 80% of patients patient will need 一个是 DVT，约80% 的患者可能发生 患者需要 chemical and mechanical prophylaxis the duration and the type of the prophylaxis 化学和机械预防持续时间和类型 is not determined there is no unanimity for it 预防未定 没有一致意见 get the patient out of bed and weight bearing as tolerated the patient will 让病人下床和卫患者应在承受能力的情况 ought to regulate the ambulation another important point some of the 下调节行走能力另一个重要的一点 一些 patient may have delay before they come to the hospital so they might be in the 患者在到达医院之前可能会延迟，因此他们可能会在 floor for many hours maybe even days so check them for DVT for ulcers for 地板上待上数小时甚至数天，因此请检查他们的 DVT 是否有溃疡 dehydration form a nutrition it can be very sick probably you need go medical 脱水 形成营养 它可能病得很重 可能您需要进行医疗 management or the medical team and you will try to do surgery early within 48 管理或医疗团队，您将尝试在 48 小时内尽早进行手术， hours because this is associated with decrease one-year mortality 因为这与降低一年死亡率 the patient have a si3n4 that will increase the mortality means 有关 患者有si3n4 会增加死亡率意味着 they're medically complicated that would increase the mortality 它们在医学上很复杂，会增加死亡率 the whole concept of treatment of hip fractures is you want to control the 髋部骨折治疗的整个概念是你想控制骨折的 impaction and collapse of the fracture and you wanna restore the alignment 撞击和塌陷，你想恢复复位 are three types stable unstable and the rest of line or you can divide them into 是三种类型 稳定 不稳定其余的线，或者你可以划分 它们变成 regular intertrochanteric fracture and the rest of light and the regular 规则的粗隆间骨折，其余的轻且规则的 pattern will be either stable or unstable 模式将偶尔稳定或不稳定 occasionally the intertrochanteric fracture extend into the subtrochanteric y 粗隆间骨折延伸到转子下 area and that is usually considered subtrochanteric fracture 区域，通常被认为是转子下骨折， so let's take this table you will treat that by a sliding head compression screw 所以让我们看这张表，您将通过滑动头压缩螺钉来治疗， you would insert the screw center Center both an AP and lateral 您将在老年患者的 AP 和侧向插入螺钉中心 in the elderly patient with severe osteoporosis it's preferred to put the 对于严重的骨质疏松症，最好将 screw in feely and posteriorly definitely not until early and 螺钉放入感觉和后部，绝对不要直到早期和 superiorly the tip apex distance should be less than 25 millimeter both in the AP and lateral x-rays 上方， when the tip Apex distance was greater than 25 millimeter it led to fixation 当顶尖距大于 25 毫米时，尖端顶点距离在 AP 和横向 X 射线中应小于 25 毫米它导致 对于固定
文章来源：http://www.360doc.com/content/17/0806/21/32243301_677166946.shtml failure you can see how we measure that in a stable fashion to haul maybe better 失败，您可以看到我们如何以稳定的方式进行测量 牵引可能比牵引更好 than for haul click this compression Shep school should not be used in 单击此压缩Shep 学校不应用于 Reverse of light fractures always look for the integrity of the lateral femoral 轻度骨折的反向 始终寻找股骨外侧皮质的完整性 cortex how about the unstable fracture that is based on loss of the integrity of the 不稳定骨折怎么样 这是基于后内侧皮质的完整性丧失， posteromedial cortex which acts as a buttress against fracture collapse in 后内侧皮质作为支撑骨折塌陷 i 在 this case the ability of the fracture to resist compressive loads this gun is not 这种情况下，骨折抵抗压缩载荷的能力，这支枪不 there so the fracture could collapse into pairs and the retroversion 存在，因此骨折可能成对塌陷， in this case will prefer to use rod it would avoid fracture collapse and medial 在这种情况下，后倾将更喜欢使用杆，它将避免骨折塌陷和骨折的内侧 displacement of the fracture it is a percutaneous technique 移位它是经皮穿刺技术 complication of that can be fracture at the tip in short rods or perforation of 并发症可能是 the anterior cortex in long guards due to mismatch between the bow of the femur 由于股骨 and the bow of the rod also screw cut out 弓和杆弓之间的不匹配而导致短杆末端 how about sliding compression help school and side plate for this type it's 骨折或长护罩前皮质穿孔 对于这种类型，它 an easy but it may cause medial displacement of the shaft if you're 很容易，但如果您要使用它，它可能会导致轴的内侧位移 going to use it you got to use it with caution 您必须谨慎使用它 of like fracture it's an unstable fracture pattern the lateral cortex is ，例如骨折 这是一种不稳定的骨折模式 外侧皮质 not intact you cannot control the compression with 不完整您无法控制压缩 sliding head screw because of the fractures lateral cortex it will not 滑动头螺钉由于骨折外侧皮质（外侧壁）它不会 support that therefore the fracture is slide 支撑因此骨折是滑动的， some people consider the supplicant Eric fracture so you can use our odd lead 有些人认为请求者 Ericfra 这样您就可以使用我们的奇数 plate dynamic Candler school or proximal femoral locking plate do not use a 铅板动态 Candler 学校或股骨近端锁定板 不要使用 sliding cap screw it can lead to make a displacement non-union and the hardware 滑动帽螺钉 它可能导致移位不愈合，并且外侧皮质的硬件 failure fracture to the lateral cortex is a 故障骨折是无 predictor free operation if you use the compression heavy screw 预测因素的操作，如果您 使用压缩重型螺钉 broken toe fracture isolated if it is avulsion in adolescence is probably due 孤立的脚趾骨折 如果它是青春期的撕脱，可能是由于 to avulsion of the iliopsoas however in an old person rollout pathological with 髂腰肌的撕脱而在老年人中推出病 aesthetic fracture 理性骨折， so what are the complication of intertrochanteric fracture the most 所以转子间骨折的 important complication is implant failure 并发症是什么 最重要的并发症是植入物失败 it usually occurs in the first three months the failure is about 60% if the 通常 发生在前三个月，如果 tip Avox distance is more than 45 millimeters the tip cables distance is 尖端 Avox 距离超过 45毫米，则故障约为 60%，尖端电缆距离也 important also if you use dynamic compression head 很重要，如果您 screw in the rest of like that probably will fail what other treatment you give 在其余部分使用动态压缩头螺钉，可能会失败您给予的其他治疗 the patient check the patient for osteoporosis you may need to start the 患者检查患者是否患有骨质疏松症 您可能需要开始给 patient on calcium and vitamin D and weight-bearing as tolerated because the 患者服用钙和维生素 D a nd可耐受的负重，因为 patient auto protect or Auto regulate and it is controversial some people like 患者会自动保护或自动调节，并且有争议的是，有些人 to putt another fracture is fracture of the neck 喜欢推杆另一个骨折是颈部骨折 and the shaft that is messed in about 30 percent the fracture femur is usually 和轴被弄乱了大约 30% 如果谁在乎骨折，股骨通常会被 comminuted if that who cares suspect a fracture of the femoral neck you can get 粉碎 怀疑股骨颈骨折 术前可以做 CT scan preoperatively check the femoral neck by floor before you start during CT扫描 术前逐层检查股骨颈 and after 60 for my neck first do closed reduction or open reduction if anatomic reduction 60岁以后我的脖子先做闭合复位或切开复位 如果 cannot be obtained you must have anatomic reduction and use 无法获得解剖复位 必须进行解剖复位并使用 cancellation schools sometimes you can use a sliding head compression school 取消 学校有时你可以使用滑动头压缩学校 Thatcher FEMA you fix it after if it's in the neck you can use retrograde I am Thatcher FEMA 你修复它如果它在脖子上 你可以使用逆行 我是 rod or a plate do not use a single device to fix both fractions 杆或板 不要使用单个设备来修复两个部分 you 你
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