Variants to optimize medical and social adaptation of gerontological patients with proximal femoral fractures

O.V. Pelypenko, O.I. Berezan, O.S. Kovalov


Background. The issue of organizing remote care of gerontological patients with fractures of the proximal femur remains an urgent problem of the present. The solution of this problem is impossible without improving rehabilitation period organization at all levels of medical care given to patients. The purpose was to study rehabilitation period features in gerontological patients with proximal femoral fractures and to develop further measures in order to optimize medical and social adaptation of these patients. Materials and methods. The analysis of remote data of examination of 711 patients with fractures of the proximal femur, who applied for medical aid in the period of 2001–2004, has been presented in the article. The localization characteristics, seasonality of traumas, gender and age features have been studied. Destiny of 301 (45.7%) patients has been reliably established. A separate group of patients (n = 258) was visited by members of a public organization, which included practitioners, interns and students. In order to improve the work of this organization, a questioning had been carried out in advance for students of medical and pedagogical higher educational institutions, concerning the attitude of youth to social projects on assistance to gerontological patients. Results. In the established group, 116 (38.5 %) patients died during the first year, 67 (22.5 %) patients lived more than 5 years since traumas. Among the patients who were visited by volunteers, the majority lived more than one year since injury (65.9 %). The age characteristics of patients and the incidence of fractures in terms of their localization have been determined. The scheme for organization of rehabilitation measures during out-of-hospital period with a clear determination of tasks and measures performed at separate levels and periods of the medical process has been proposed. Provision of assistance on medical and social adaptation of patients was carried out with the participation of doctors, future doctors — students and interns. In order to optimize the work of mentioned organization and to involve students into the advisory group, in 2017, an anonymous survey was conducted among 263 students of various courses at medical and pedagogical universities. Conclusions. The obtained data indicate a high level of readiness of students for participation in public medical projects and highlight the problematic aspects of conducting educational and organizational work among young people.


femoral fracture; gerontological patients; rehabilitation; medical and social projects


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