Treatment of proximal metaepiphyseal femoral fractures in senile patients

A.Yu. Fil, Yu.Ya. Fil, O.O. Maksymovych, N.V. Levytskyy

Abstract


Background. The incidence of femoral neck fractures, one of the leading causes of death in elderly patients, is increasing as an average life duration and prevalence of osteoporosis continue to rise. Fracture site displacement, patients’ age, comorbid disorders, pre-fracture activity level are some of the critical factors in determining the management of femoral neck fractures. The purpose of the study was to evaluate the advantages and disadvantages in the treatment of proximal femoral fractures in elderly patients based on a retrospective material. Materials and methods. An analysis was performed of 155 medical records of patients with proximal femoral fractures who underwent treatment at the orthopedic and trauma department of Lviv Municipal Clinical Hospital N 8 from 2010 to 2016. The classification of Association for Osteosynthesis/Association for the Study of Internal Fixation was used to detail the fractures of the proximal femur. For further study, patients were divided into two groups. Results. The long-term observation lasted from 3 months to 1 year. In the vast majority, the verticalization of patients began 12 hours after surgery. In patients who were operated in the first 24 hours, the average length of hospital stay was from 7 to 10 days. Patients from the control group did not experience problems caused by hypodynamia, namely: hypostasis, genitourinary inflammation or other diseases. Conclusions. The results obtained after osteosynthesis in most cases were unsatisfactory. Osteosynthesis in the patients of the observed age group does not allow activating patients in the early stages, which in turn leads to the progression of concomitant diseases. The use of early surgical intervention such as the primary hip joint replacement makes it possible to achieve better results and to prevent aggravation of concomitant pathology.


Keywords


femoral head fracture; hip joint replacement; intrame-dullary osteosynthesis; patients of senile age

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DOI: https://doi.org/10.22141/1608-1706.6.18.2017.121185

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