Stručni rad

Fractures of the Proximal Femur in the Elderly

Aljoša Matejčić
Miroslav Bekavac-Bešlin
Ivica Mihovil
Mladen Tomljenović
Ivan Krolo
Borki Vučetić

Sažetak

Fractures of the proximal femur are a substantial problem in the elderly. These fractures primarily are due to bone fragility in the elderly caused by osteoporosis. This population is burdened with numerous chronic illnesses that aggravate and complicate surgical treatment of the injured. According to latest figures, death rates among patients with these fractures are by 15% higher than in those free from these injuries, and 20% of the injured will never be able to walk independently again. According to our own experience and literature data, surgical treatment significantly reduces the mortality of the injured and improves their quality of life by providing by far better functional results than conservative treatment. Results of operative treatment for proximal femur fractures were compared between two periods of time at a 10-year interval (1988/1989 and 1998/1999). Comparison between these two time periods showed the frequency of hospital admission and operative treatment for this pathology to have increased by more than 100% in 10 years, so that at present this group of patients account for more than 45% of the capacity and operative schedule of the Division of Traumatology, Department of Surgery, Sestre milosrdnice University Hospital in Zagreb. During the latter 2-year period (1998/1999), there were 372 injured in total, 78 (21%) of them male and 294 (79%) female, mean age 73 years (69 in male and 79 in female patients). The mean duration of hospitalization was 15 days with 5-day waiting for the operation. During the same time period, eight (2%) patients were treated conservatively. A 2.5% (n=9) perioperative mortality rate was recorded. Fracture of the neck of femur was found in 152 (41%) patients; 47% of them were treated by use of partial hip prosthesis, 10% with total hip prosthesis, and 42% with a 130-degree angle plate. Out of 205 pertrochanteric fractures, 130-degree angle plate was used in 50%, 95-degree angle plate in 22%, and dynamic hip screw in 28% of cases. Operative treatment combined with a well planned rehabilitation program consistent with the type of surgery and individual patient condition has evident and great advantages, and has been recognized as the treatment of choice for this pathology.

Ključne riječi

Femoral fractures, therapy; Femoral fractures, surgery; Fracture fixation; Age factors; Aged

Hrčak ID:

14705

URI

https://hrcak.srce.hr/14705

Datum izdavanja:

1.3.2002.

Podaci na drugim jezicima: hrvatski

Posjeta: 3.190 *