Исходы хирургического лечения пострадавших пожилого возраста с переломом проксимального отдела бедренной кости

Abstract

The purpose — to study the efficacy of intramedullary osteosynthesis and hip arthroplasty in the treatment of proximal femoral fractures in elderly people with various weight and height characteristics. Material and methods. A prospective analysis of the results of treatment of 181 patients aged 60 to 93 years from 2016 to 2021 was performed. We analyzed 77 cases with extraarticular fractures of the proximal femur operated on by arthroplasty and 104 cases treated by intramedullary block osteosynthesis. Conclusions. The treatment of fractures of the vertebral femur in patients with a femoral fracture should be based on intramedullary fixation with the use of a locking pin. A similar tactic is presented in the draft of the relevant Russian clinical guidelines. However, the presence of concomitant pathology in some patients (coxarthrosis on the affected side, severe osteoporosis, obesity, etc.) necessitates the inclusion of endoprosthesis in the primary surgical treatment of extraarticular fractures of the proximal femur. During treatment, increasing risks associated with the patients’ comorbid background should be considered and prevention of possible intra- and postoperative complications should be performed.