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摔倒后没事不代表没骨折 若有这些症状或需"开刀"

科普中国-乐享健康 2017-11-24

  提起骨折,大多数人都会想到疼痛难忍、举步维艰等词,但有些中老年人在散步时不小心摔倒,爬起来后只感觉有些酸痛,走路也没有受到太大影响,于是便认为自己过几天就没事了,然而在几天之后,疼痛感却越来越明显,到医院一检查,发现自己竟然因为摔倒而发生了股骨颈骨折,需要接受手术治疗,这是怎么回事?

  首先让我们来了解一下股骨颈。连接骨盆和大腿的关节被称为髋关节,髋关节由骨盆侧的髋臼和大腿侧的股骨头组成,而在股骨头中,连接大腿骨的部分就是股骨颈。为股骨头提供营养的血管大多需要经过股骨颈,如果股骨颈骨折,股骨头的营养供应便会受到影响,在情况比较严重时,股骨头就有可能发生坏死。因此,股骨颈骨折后一定要及早治疗。

  为什么有些中老年人在股骨颈骨折后不会感到剧烈疼痛,并且还能继续走路呢?事实上,股骨颈骨折分为高能量损伤和低能量损伤两种,高能量损伤通常发生在年轻人身上,多由车祸、从高处坠落等原因引起;低能量损伤通常发生在患有骨质疏松的中老年人身上,多由摔倒、磕碰等引起。对于低能量损伤的股骨颈骨折而言,骨折处可能相对稳定,没有出现明显位移,于是疼痛感并不明显。但如果置之不理,随着关节活动,骨折处将产生位移,这不仅会增加治疗难度,还有可能引起一系列并发症。

  那么,中老年人在摔倒、磕碰后该如何判断自己是否发生股骨颈骨折了呢?

  1.如果在大腿近端、臀部、腹股沟等处出现剧烈疼痛,而且伤侧下肢难以正常活动,甚至出现伤侧下肢外旋(脚掌严重向外撇)等情况,说明发生股骨颈骨折的可能性很大。此时应该待在原地,尽量不要活动下肢,同时拨打120急救电话或寻求他人帮助,以便及早就医。

  2.在能够正常走路的情况下,如果腹股沟、髋部等处出现酸胀、疼痛等感觉,而且在走路时这些感觉加剧,就说明存在股骨颈骨折的可能性,此时应停止负重和活动,并及时就医。

  在就医时,医生会根据患者股骨颈骨折的情况制定不同的治疗方案,如果情况不太严重,患者只需要通过闭合复位、微创内固定等治疗方式即可恢复;如果情况比较严重,患者可能需要接受髋关节置换手术等。

  作者:复旦大学附属中山医院骨科副主任医师陈增淦、复旦大学附属中山医院骨科副主任医师周建平、复旦大学附属中山医院骨科主治医师李娟

  “达医晓护”供稿

责任编辑:王超

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