DHS、Gamma钉、PFNA、InterTAN、关节置换，对于转子间骨折应，选哪个？

Treatment 治疗

Scope of Application 适用范围：

1、DHS，Stable fracture patterns in patients with good bone quality

骨质良好的患者的骨折类型稳定型。

2、Gamma Nail 

伽玛钉

Unstable fractures in younger patients with good bone stock

骨质良好的年轻患者的不稳定骨折。

3、PFNA Unstable fractures in osteoporotic bone; high risk of DHS failure

适用于骨质疏松性不稳定骨折;使用DHS风险高。

4、InterTAN Unstable fractures in patients with good bone quality

骨质良好的患者的不稳定骨折。

5、半关节置换术Unstable fractures with poor bone quality and comminution; select cases with pre-existing hip arthritis or AVN

不稳定的骨折，骨质差和粉碎;选择已有髋关节炎或 股骨头坏死的病例。

In summary: 总结：

DHS is ideal for simple, stable intertrochanteric fractures

DHS 是简单、稳定的转子间骨折的理想选择

Gamma nail and interTAN can be used for unstable fractures in patients with good bone stock

Gamma钉和 interTAN 可用于骨质良好的患者的不稳定骨折

PFNA is preferable for unstable fractures in elderly osteoporotic patients

PFNA 更适用于老年骨质疏松症患者的不稳定骨折

Hemiarthroplasty is reserved for very unstable comminuted fractures in poor bone

半关节成形术仅用于非常不稳定的、骨质差的粉碎性骨折

The choice depends on the fracture pattern, bone quality, and patient factors. Surgeon experience with each implant is also an important consideration.

选择取决于骨折类型、骨质和患者因素。外科医生对每个植入物的经验也是一个重要的考虑因素。

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