Objective: To introduce the reduction concept of anteromedial cortical support in the treatment of intertrochanteric fracture, summarize the history, characteristics, biomechanics, and clinical applications, discuss the unsolved problems and prospect the future directions.
Methods: Relevant domestic and foreign studies on cortical support reduction of intertrochanteric fracture in recent years were reviewed. Conclusions were drawn combined with clinical experience.
Results: The positive cortical supportive reduction of intertrochanteric fracture, as a stable non-anatomical fracture reduction technique, has dual effects on mechanical buttress and biological bone healing. It does not increase the difficulty of doctors' surgical procedure. For patients, it decreases the loss of femoral neck length, the loss of neck-shaft angle, the incidence rate of coxa vara, and maintains stable mechanical structure of the pelvis. It also shows a lower rate of instrument-related complications, and higher limb function scores. The mechanical stability of medial cortex apposition is more important than that of anterior cortex. For the best stability of the fracture, both sides should get positive support reduction pattern.
Conclusion: Anteromedial cortical support reduction can improve the postoperative stability of intertrochanteric fracture, enable better imaging and functional prognosis. As a kind of non-anatomic form of functional reduction, it can be used as a suboptimal choice secondary to anatomic reduction.
目的: 介绍股骨转子间骨折内固定治疗中的前内侧皮质支撑复位理念，总结其历史、特征、生物力学及临床应用研究进展，提出存在的问题并展望研究方向。.
方法: 查阅近年来国内外针对股骨转子间骨折正性皮质支撑复位的相关研究，结合临床应用经验进行归纳总结。.
结果: 股骨转子间骨折的前内侧皮质正性支撑复位，作为一种稳定的非解剖骨折复位技术，具有力学结构支撑和生物学促进愈合的双重效果。皮质支撑复位对医生来说并不增加手术操作难度，对患者而言股骨颈长度丢失少，颈干角内翻发生率低，骨盆的正常力学结构得以维持，术后器械相关并发症发生率低，肢体功能评分高。内侧皮质支撑的力学性能高于前侧皮质支撑，当两者均达到正性对位时骨折稳定性最佳。.
结论: 前内侧皮质支撑复位能分担内固定器械的力学载荷，提高股骨转子间骨折内固定术后稳定性，作为一种功能复位形式，可作为解剖复位之外的次选。.
Keywords: Intertrochanteric fracture; anteromedial cortex; fracture reduction; internal fixation; positive cortical support.