小结
定义
病史和体格检查
关键诊断因素
- 跌倒或创伤史
- 受累的髋部、腹股沟或大腿疼痛
- 无法负重或无法移动髋部
- 腿缩短且外旋
- 危险因素
危险因素
- 骨质疏松症/骨质减少
- 老年
- 摔倒
- 体重指数 (BMI) 较低
- 女性
- 高能量创伤
- 药物治疗
- 痴呆
诊断性检查
首要检查
- X线平片
- 全血细胞计数
- 尿素和电解质
- 葡萄糖
- 血型鉴定和不规则抗体筛查（Group and save）
- 凝血筛查
- 心电图（ECG）
需考虑的检查
- 盆腔 MRI
- 骨盆 CT
- 锝骨扫描
治疗流程
适合手术
目前不适合手术：未接受临终关怀
目前不适合手术：正在接受临终关怀
术后
撰稿人
专家顾问
Michael Barrett, MBChB, FRCS (Tr & Orth), PG Cert Med Ed
Consultant Trauma and Orthopaedic Surgeon
Cambridge University Hospitals NHS Foundation Trust
Cambridge
UK
利益声明
MB is a director of Orthohub.xyz, an online education platform for orthopaedic surgeons. Orthohub.xyz receives sponsorship from the healthcare industry.
Acknowledgements
BMJ Best Practice would like to gratefully acknowledge the previous team of expert contributors, whose work has been retained in parts of the content:
Zoe Little
ST6 in Trauma and Orthopaedics
Epsom and St Helier University Hospitals
Epsom
UK
Brett Griffiths
Specialist Registrar
Norfolk and Norwich University Hospitals
Norwich
UK
Hiba Khan
ST4 in Trauma and Orthopaedics
Croydon University Hospital
London
UK
利益声明
ZL, BG, and HK declare that they have no competing interests.
同行评议者
Antony Johansen, MB BChir
Consultant Orthogeriatrician
University Hospital of Wales
Cardiff
UK
简介
AJ is clinical lead for the National Hip Fracture Database, Royal College of Physicians, London, UK.
利益声明
AJ has been a co-applicant or collaborator in successful applications for non-commercial grants from the NIHR Health Technology Assessment Programme, Physiotherapy Research Foundation, and Versus Arthritis.
编辑
Emma Quigley
Section Editor, BMJ Best Practice
利益声明
EQ declares that she has no competing interests.
Rachel Wheeler
Lead Section Editor, BMJ Best Practice
利益声明
RW declares that she has no competing interests.
Luisa Dillner
Head of Research and Development, BMJ
利益声明
LD declares that she has no competing interests.
Julie Costello
Comorbidities Editor, BMJ Best Practice
利益声明
JC declares that she has no competing interests.
Adam Mitchell
Drug Editor, BMJ Best Practice
利益声明
AM declares that he has no competing interests.
鉴别诊断
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- 耻骨支骨折
- 股骨干或股骨粗隆下骨折
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